Marginal zone lymphoma (MZL) accounts for approximately 10 % of non-Hodgkin lymphoma (NHL). It can be divided into three specific entities:extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), nodal marginal zone lymphoma (NMZL) and splenic marginal zone lymphoma (SMZL). MALT lymphoma is the most frequent overall, representing 7.5 % of all NHLs. Reports on research progress of MZL in the 58th American Society of Hematology Annual Meeting covered multiple respects which ranged from basic research to clinical prognosis and treatment. Based on the technology such as flow cytometry, cytogenetics and FISH, further study on pathogenesis of MZL is developing, and new prognostic index system can help to stratify patients more exactly and give a guidance to treatment. What's more, the change of therapy and new drugs will benefit to the clinical efficacy and safety of MZL patients.

Objective To observe the effect of comprehensive rehabilitation on POEMS syndrome during sequel period. Methods Two cases of POEMS syndrome with multiple peripheral nerve injury as the main manifestation received physical therapy, occupational therapy, acupuncture, surface electromyography biofeedback and other comprehensive rehabilitation treatment. Results After treatment, the muscle strength, trunk balance, standing balance ability, activities of daily living (ADL) improved. The score of Berg Balance Scale increased from 18 to 28 in the first case, the modified Bathel Index increased from 55 to 70 in the second case. Conclusion Comprehensive rehabilitation can improve the function of patients with POEMS syndrome during sequel period, and surface electromyography biofeedback plays an im-portant role.

Objective: To understand the relationship between perceived social support, psychological capital and job satisfaction, and analyze the mediating effect of psychological capital between perceived social support and job satisfaction. Methods: In 2017, June to July, we use cluster random sampling method to evaluate 888 medical staff from 5 hospitals in Jinan and Yantai in Shandong provience by Perceived Social Support Scale、PsyCap Questionnaire and MinnesotaSatisfaction Questionnaire. Results: Correlation analysis showed that perceived social support was significantly positively correlated with self-efficacy, hope, resilience, optimism and job satisfaction (r=0.42, 0.42, 0.56, 0.47, P<0.05) . There was a significant positive correlation between job satisfaction and self-efficacy, hope, resilience and optimism (r=0.45, 0.50, 0.43, 0.46, P< 0.05) . The structural equation model shows that hope and optimism play a significant partly mediating effect between perceived social support and job satisfaction. Conclusion Perceived social support is a positively predictive factor of job satisfaction in medical staff. The Increase of perceived social support and psychological capital are conducive to improving job satisfaction of medical staff's.

Objective: To investigate the relationship between total homocysteine (tHcy) levels and sarcopenia among the elderly, so as to provide insights into the prevention and treatment of sarcopenia. Methods: The elderly aged 65 years and older who participated in the physical examination of Shibantan Township Health Center in Xindu District, Chengdu City from April to June 2021 was selected as the study subjects. The elderly with sarcopenia (diagnosed according to the diagnostic criteria of the Asian Sarcopenia Working Group in 2019) and non-sarcopenia were matched 1︰1 by gender and age (±2 years). Demographic information, skeletal muscle mass, skeletal muscle strength and tHcy were collected through questionnaire surveys, physical examination and laboratory testing. Multivariable conditional logistic regression model was used to explore the relationship between tHcy and sarcopenia. Results: A total of 320 individuals, including 160 sarcopenia patients and 160 non-sarcopenia individuals, were investigated. There were 138 males (43.13%) and 182 females (56.87%), with a median age of 71.00 (interquartile range, 6.00) years. There were 57 drinkers (17.81%), 78 smokers (24.37%), 173 cases of hypertension (54.06%) and 124 cases of hyperhomocysteinemia (38.80%). Multivariable conditional logistic regression analysis showed that elevated tHcy was associated with an increased risk of sarcopenia (OR=1.107, 95%CI: 1.024-1.197), after adjusting for smoking, alcohol consumption, hypertension, waist circumference, neck circumference, body mass index, platelet count and high density lipoprotein cholesterol. Conclusion Elevated tHcy is associated with sarcopenia, and intervention should be carried out for the elderly with higher tHcy.

Objective To explore the expression characteristic of serum mir-16,mir-21,mir-29a, mir-92a and mir-143 in colorectal cancer , evaluate the clinical significance of candidate miRNAs in CRC diagnosis.Methods Case-control study was used.The expression levels of serum mir-16,mir-21,mir-29a, mir-92a and mir-143 from 50 CRC patients and 27 normal controls were detected by real-time PCR, the levels of miRNAs expression in serum of 8 CRC patients 1 day before and 7 days after radical surgery were analyzed.The sensitivity and specificity of serum miRNAs expression for the diagnosis of colorectal cancer were evaluated using the receiver operating characteristic ( ROC) curve.Results The expression level of mir-16, miR-21, mir-92a in serum of patients with CRC were (75.55 ±37.73), (35.96 ±23.81), (24.79 ±8.97) fmol/ml, significantly higher than that of the healthy control group (32.73 ±18.94), (24.36 ±13.27), (16.36 ±5.58) fmol/ml (tmir-16 =2.77, tmir-21 =2.34, tmir-92a =3.85,P <0.05).However, the expression levels of mir-29a and mir-143 showed no significant difference between two groups (tmir-29a=-0.17, tmir-143 =1.59,P>0.05).In addition, serum miR-16 and miR-92a levels of CRC patients 7 days after tumor resection were (36.02 ±19.95), (14.82 ±7.78) fmol/ml, significantly lower than that before operation (62.18 ±34.17), (24.06 ±12.99) fmol/ml (tmir-16 =3.59, tmir-92a =2.60,P<0.05).Area under the ROC curve ( AUC) of combined detection of mir-16, miR-21and mir-92a was 0.877, the sensitivity and specificity were 88% and 85%, respectively, which was higher than any of 3 miRNAs alone and the conventional tumor marker CEA.Conclusion Combination of mir-16, mir-21 and mir-92a in the diagnosis of CRC shows a better sensitivity and specificity , which would be expected as new tumor biomarkers for noninvasive diagnosis and monitoring progression of colorectal cancer.

Objective T o observe the expression changes of hypoxia inducible factor-1α (H IF-1α) and vascular endothelial grow th factor-A (V E G F-A ) in rats w ith arrhythm ias, and to explore the differences of the expression pattern in the tw o indicators of acute m yocardial ischem ia caused by arrhythm ias and coronary insufficiency. Methods T he arrhythm ia w as induced by C aC l2, and the expression changes of H IF-1α and V E G F-A w ere detected by im m unohistochem istry, W estern blotting and real-tim e PC R w ithin 6 h after the arrhythm ia in rats. Results T he expression of H IF-1α and V E G F-A show ed diffuse in the m yocardial tissue of rats died from arrhythm ias. B oth of them increased in the early arrhythm ia, then decreased. E xtensive m yocardial ischem ia happened at the beginning of arrhythm ia occurrence and its range didn't expand w ith tim e. Conclusion T he expressions of H IF-1α and V E G F-A in m yocardium of the rats w ith arrhythm ia can provide evidence for the differential diagnosis of acute m yocardial is-chem ia caused by fatal arrhythm ia and coronary insufficiency.

Objective To investigate the diagnosis and treatment of primary hyperparathyroidism ( PHPT) initially with urinary calculus .Methods The clinical data of 26 patients who diagnosed as PHPT ini-tially with urinary calculus were retrospectively reviewed .Results There were 22 cases with bilateral urinary calculus and 4 cases with unilateral relapsed urinary calculus .Ultrasonography , CT and radionuclide were helpful to determine the location of the neoplasia .24 cases underwent percutaneous nephroscope or ureteroscopy pneu-matic ballistic lithotripsy , 2 cases discharged ureteral calculi by themselves .All patients were performed surgical treatment of PHPT , which was confirmed by intraoperative frozen pathology and postoperative pathological exami -nation.There was great improvement of clinical symptoms after surgical procedures .The preoperative serum calci-um, urine calcium and parathyroid hormone elevated , while serum phosphate decreased .The postoperative indi-cators were just the opposite .The difference had statistical significance ( P<0.05 ) .Conclusions Laboratory investigations and imaging studies are very important to diagnose PHPT initially with urinary calculus .The para-thyroid surgery can remarkably reduce the calculus recurrence and improve renal function .

Objective:To evaluate the accuracy of lung ultrasound score (LUSS) in predicting emerging hypoxemia after tracheal extubation in the patients in postanesthesia care unit (PACU).Methods:A total of 333 patients of both sexes, aged 18-89 yr, of American Society of Anesthesiologist physical statusⅠ-Ⅲ, scheduled for elective abdominal surgery, were included in the study.Lung ultrasound examinations were performed before operation (T 0) and on admission to PACU (T 1), and the LUSS were recorded as LUSS 0 and LUSS 1.Arterial blood gas analysis was conducted at 20 min after tracheal extubation, and oxygenation index (PaO 2/FiO 2) were recorded.Patients were divided into 2 groups according to the oxygenation index: PaO 2/FiO 2<300 mmHg group (hypoxemia group), and PaO 2/FiO 2≥300 mmHg group (non-hypoxemia group). Multivariate logistic regression analysis and the receiver operating characteristic curve were used to evaluate the accuracy of LUSS 1 in predicting the emerging hypoxemia after extubation in the patients in PACU. Results:The incidence of emerging hypoxemia in PACU after extubation was 9.0%.Multivariate logistic regression analysis indicated that LUSS 1 and body mass index were independent risk factors for emerging hypoxemia after extubation in the patients in PACU.The area under the ROC curve for LUSS 1 was 0.873 ( P<0.001, 95%CI 0.812-0.935). The patients with LUSS 1<7 had a lower risk of hypoxemia after extubation (LR -=0.15, 95%CI 0.05-0.45), and the patients with LUSS 1>10 had a higher risk of hypoxemia after extubation (LR + =17.25, 95%CI 7.35-40.51). Conclusion:LUS can effectively predict the development of hypoxemia after tracheal extubation in the patients in PACU.

A comprehensive regulation mechanism,as one of the five basic healthcare system components,plays an important role in safeguarding the health and life rights of all nationals of a country.The authors explored the construction of such a mechanism and related reform experiences of the healthcare industry in the context of building a healthy China.On such basis,the paper analyzed in depth the connotation of the comprehensive regulation and the existing challenges,in order to propose countermeasures for the establishment of a proactive,comprehensive and coordinated comprehensive regulation mechanism.

Objective: To investigate the characteristics in pathological diagnosis, clinical features, treatment and prognosis of adult patients with pediatric-type follicular lymphoma (PTFL) . Methods: The clinical and pathological features, laboratory examination, diagnosis and treatment, follow-up results of 5 adult PTFL patients admitted in Jiangsu Province Hospital were retrospectively analyzed, and literature review was conducted in combination with related reports. Results: All 5 patients developed PTFL in their adulthood with a median age of 22 years old (15-33 years) . The initial inanifestation of the disease was local painless lymphadenopathy with no fever, night sweats, emaciation or other systemic B symptoms. Pathological characteristics including typical large follicular structures and high proliferation index were found. Meanwhile, additional clonal rearrangement of immunoglobulin heavy chain gene was observed. However, there was no BCL-2 expression in histochemistry as well as BCL-2 gene abnormality in fluorescence in situ hybridization among these PTFL patients. These adult PTFL patients were all in stage Ⅰ-Ⅱ of the disease. For treatment, they were only treated with local surgical excision after diagnosis while didn’t receive subsequent local radiotherapy or systemic immunochemotherapy. During a median follow-up of 27 months, the 5 cases of PTFL kept in a state of sustained complete remission. Conclusion Adult-onset PTFL is characterized by high pathological proliferation index, while no BCL-2 expression or BCL-2 gene abnormality. Besides, PTFL is clinically manifested as a localized disease that can achieve a quite good prognosis through local surgical intervention. The aforementioned attributes of PTFL are distinctly different from classic adult follicular lymphoma.