Primary mediastinal large B-cell lymphoma represents a distinct entity with unique clinicopathologic features and a molecular gene-expression signature. There is no standard regimens. Retrospective analysis suggests that dose-dense and dose-intensive regimens are more effective than CHOP. The addition of rituximab may mitigate such difference. The role of mediastinal radiotherapy upon completion of chemotherapy remains unclear. The role of PET scanning requires prospective examination, which may allow the de-escalation of treatment if it can be shown to yield reliable prognostic information.

Objective To compare the efficacy and toxicity of melphalan + prednisone + thalidomide regimen (MPT) and melphalan + prednisone regimen (MP) in the treatment of multiple myeloma (MM).was given 100-200 mg/d everyday. 21 cases in MP group, the dose of melphalan and prednisone were the same as that in MPT group. The efficacy was evaluated after 6 cycles of treatment. Results The overall response rate (ORR) of MPT group and MP group were 65.4 % and 42.9 %, respectively (P＞O.05). The median response time in MPT group versus MP group was 2 months versus 3 months. Compared with the MP group. the increase of hemoglobin and albumin concentration in the MPT group is significantly higher (P＜ 0.05).The incidence of adverse effects of MPT group was higher than that of MP group (P ＜0.05), but the percentage of grade 3 and grade 4 toxicity was no different. The median PFS in MPT group was 11 months, 2-year PFS was 66.18 %. Conclusion Compared with MP, MPT could achieve higher response rate, improve the life quality and prolong the survival time of MM patients with better tolerance.

OBJECTIVETo explore the effects of early intervention of acupuncture on urinary function reconstruction of neurogenic bladder after spinal cord injury, so as to find the optimal treatment timing of acupuncture.

METHODSFifty-three patients of neurogenic bladder after spinal cord injury were randomly divided into a prior-to-catheter group (25 cases) and a posterior-to-catheter group (28 cases). For the prior-to-catheter group, one week before the removal of catheter, acupoints on the abdomen and back such as Guanyuan (CV 4), Zhongji (CV 3), Baliao (Shangliao (BL 31), Ciliao (BL 32), Zhongliao (BL 33), Xialiao (BL 34), Jiaji (EX-B 2) and acupoints at distal end such as Zusanli (ST 36) and Sanyinjiao (SP 6) were selected; after the catheter removal, simple method. of water column was used to measure bladder capacity pressure to classify the type of bladder, and then different acupuncture manipulations were given; intermittent catheterization was performed if condition was allowed. The posterior-to-catheter group applied identical treatment after removal of catheter as the prior-to-catheter group. The treatment was given 5 times per week; after one-month treatment, five aspects including the time of first effective urination, time of establishing reflex urination, average residual volume of urine, time of residual urine less than 100 mL and quality of life (QOL) were evaluated.

RESULTSAfter treatment, the time of first effective urination, time of establishing reflex urination, average residual volume of urine and time of residual urineless than 100 mL in the prior-to-catheter group were all superior to those in the posterior-to-catheter group (all P<0. 05) ; the score of QOL was improved in two groups after treatment (both P<0. 01), but the difference between two groups was not statistically significant (P>0. 05); each index of urination function was not significant among patients with different injured segments of spinal cord (all P>0. 05).

CONCLUSIONThe early intervention of acupuncture (prior to catheter) has obvious improving function on establishing balanced bladder in patients with neurogenic bladder after spinal cord injury, which is superior to acupuncture intervention after removal of catheter, however, the effects of different injured segments on establishing balanced bladder are not different.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; complications ; Treatment Outcome ; Urinary Bladder ; physiopathology ; Urinary Bladder, Neurogenic ; etiology ; physiopathology ; therapy ; Urination ; Young Adult

Objective To investigate the inflammation levels of 2-diabetes patients before and after 3 months of improving glycemic control.Methods A longitudinal study was performed in a subgroup of 48 subjects with T2D and poor glycemic control.Forty-four healthy individuals were taken as control group.The serum concentration of C-reactionprotein (CRP),interleukin-6 (IL-6),interleukin-6 (IL-8),transforming growth factor-β1 (TGF-β1) and transforming growth factor-β1 (MCP1) in all participants were measured simultaneously by multiplexed Luminex assay.Results The serum levels of CRP,MCP-1 of 2-diabetes patients were 3.96 (3.45,5.58) mg/L and (195.0± 129.8) ng/L,significant higher than those in control group (2.25 (1.24,3.22) mg/L,(148.5±85.7) ng/L),and the differences were significant(t=-2.580,P=0.010;t=-2.118,P =0.047).No significant difference was found in the serum levels of IL-6,IL-8,TGF-β lbetween the two groups (P＞0.05).TGF-β1 level in patients with good glycemic control decreased to 26.85 (23.17-31.12) ng/l,significant lower than that before glycemic control (43.5(26.5-62.25) g/L;Z=-2.191,P=0.028),and there were no significant differences among the other 4 kinds of inflammatory factors before and after blood glucose control(CRP:Z =-0.937P =0.372;IL-6:Z =-0.875,P =0.396;IL-8:Z =-1.215,P =0.286;MCP-1:t =-1.846,P=0.065).Conclusion Low grade systemic inflammation status in T2D patients.Improvement of glycemic control reduces TGF-β1 levels and plays a key role in delaying the development of diabetic nephropathy.

The traditional clinical trail designs always depend on expert opinions and lack statistical evaluations. In this article, we present a method and illustrate how population parameter uncertainty may be incorporated in the overall simulation model. Using the techniques of clinical trail simulation (CTS) and setting up predictions on the basis of pharmacokinetics-pharmacodynamics (PK-PD) models, we advance the modeling methods for simulation, for treatment effects, and for the clinical trail power under the given PK-PD conditions. Then we discuss the model of uncertainty, suggest an ANOVA-based method, add eta2 statistics for sensitivity analysis, and canvass the effect of uncertainty about population parameters on clinical trail power. The results from simulations and the indices derived from this type of sensitivity analysis may be used for grading the influence on the prediction quality of uncertainty about different population parameters. The experiment results are satisfactory and the approach presented has practical value in clinical trails.
Algorithms ; Clinical Trials as Topic ; methods ; Computer Simulation ; Data Interpretation, Statistical ; Humans ; Models, Biological ; Monte Carlo Method ; Pharmacokinetics ; Pharmacology ; Uncertainty

Objective The purpose of this study is to investigate the apoptosis mechanisms of glioblasto-ma cell line U87 induced by sodium cantharidinate ( SCA) in vitro.Methods Growth inhibition of U87 by 0.625μg/mL,1.25μg/mL,2.5μg/mL,5μg/mL SCA at 24 h,48 h,72 h were analyzed by MTT assay respec-tively.Morphological changes of U 87 nuclear were detected by fluorescence microscope .U87 cell apoptosis and cell cycle arrest were detected after SCA treatment for 24 h and 48 h by flow cytometry.The changes of apoptosis-related genes Bcl -2,Bax,Caspase-3 expression were analyzed after 24 h of SCA treatment by RT -PCR as-say.Results MTT assay showed that growth inhibition of U 87 cell induced by SCA was accompanied with the in-creased drug concentration ,Hoechst33258 staining showed the morphology of apoptotic U 87 cells nucleui ,chromo-some condensation ,nuclear condensation ,some nuclear fragmentation and formation of apoptotic bodies .Flow cy-tometry showed that SCA could induce cell cycle arrest at the G 2/M phase,and could induce apoptosis of U87.RT-PCR results showed that after 24 h of SCA treatment caspase -3,bax expression of U87 was significantly higher than the control group(P<0.05),bcl-2 expression was significantly decreased (P<0.05),and P53 expression was not significantly increased(P>0.05).Conclusion Our results demonstrate that SCA can inhibit U87 pro-liferation and induce apoptosis of U 87 .

Objective: To study the effects of Rhizoma Polygoni Cuspidati on expression of transforming growth factor beta 1(TGF-?1) in rats with pulmonary fibrosis induced by bleomycin.Method: 120 male SD rats were randomly divided into five groups: the control group(n=30),the bleomycin(BLM) model group(n=30),the Rhizoma Polygoni Cuspidati prophylactic group(n=30),the 7 th day treatment group(n=20) and the 28 th day treatment group(n=10).The rat models of pulmonary fibrosis were established by intratracheal injection of bleomycin, while the control group was given with normal saline instead.The Rhizoma Polygoni Cuspidati prophylactic group received intragastric administration with 4ml?kg-1?d-1 Rhizoma Polygoni Cuspidati 2 days before setting up models.The 7 th day treatment group and the 28 th day treatment group received the treatment on the seventh day and the twenty-eighth days after establishing models respectively.The other two groups received saline instead.On the 3rd,7th,14th,28th,42th and 56th day after instillation of bleomycin,lung samples were obtained and the content of hydroxyproline in lung tissue homogenate was detected to judge the degree of fibrosis and the therapeutic efficacy.At the same time the express of TGF-?1mRNA and TGF-?1 protein was examined by RT-PCR and immunohistochemical method.Results: Compared with the model group,the content of hydroxyproline in the Rhizoma Polygoni Cuspidati prophylactic group and the 7th day treatment group decreased significantly(P

Objective To evaluate the effects of adiponectin on the mitochondrial damage in septic rats with lung injury .Methods Sixty male Wistar rats ,aged 7-8 weeks ,weighing 180-220 g ,were randomly divided into 3 groups (n=20 each) using a random number table :sham operation group (S group) ,sepsis group (SEP group) and adiponectin group (APN group) .The animals were anesthetized with intraperitoneal 2% pentobarbital sodium 50 mg/kg .Sepsis was produced by cecum ligation and puncture (CLP) .In APN groups ,gene recombinant adiponectin 6 mg/kg was injected intraperitoneally at 12 h after CLP .At 24 h after the operation ,10 rats from each group were chosen and sacrificed ,and lungs were removed for detection of interleukin-6 (IL-6 ) and high-mobility group box-1 (HMGB1 ) contents . The mitochondria of lung samples were isolated for measurement of the malondialdehyde (MDA ) content and degree of mitochondrial swelling and mitochondrial activity . The survival rates within 7 days after operation were recorded in the left 10 rats in each group .Results Compared with S group , IL-6 and HMGB1 contents in lung tissues and MDA content in the mitochondria were significantly increased ,the degree of mitochondrial swelling was increased , and the mitochondrial activity and survival rates within 7 days after operation were decreased in SEP group ( P<0.05 ) . Compared with SEP group , IL-6 and HMGB1 contents in lung tissues and MDA content in the mitochondria were significantly decreased ,the degree of mitochondrial swelling was reduced ,and the mitochondrial activity and survival rates within 7 days after operation were increased in APN groups ( P< 0.05 ) .Conclusion Adiponectin can attenuate lung injury and raise the survival rates in septic rats ,and reduction of mitochondrial damage in lung tissues is involved in the mechanism .

Objective To treat complex wounds of the chest wall tuberculosis by the use of wound healing techniques (focal debridement + the VSD) and joint plastic surgery (transfer of skin flap, skin graft, flap stuffing, etc) and to explore the clinical features of the tuberculous chest wound, the feasibility and effectiveness of treatments.Methods Clinical data of 11 hospitalized patients with chest wall tuberculosis were collected during 2012-2014.The therapeutic effect, intraoperative and postoperative complications, and postoperative follow-up were retrospectively analyzed.Results Among 7 cases using lesion debridement, VSD suction drainage and local flap repair (skin grafting), 6 cases were cured.The response rate was 90.9%.All 4 cases using debridement and local flap repair (skin grafting) were cured.Only one case of recurrence was observed during the follow-up period of 3-34 months.Conclusions Using of wound healing techniques with plastic surgery is an effective treatment, which has good therapeutic effect on the wound deeply infiltrated.

Objective:To investigate the information demand level and its influencing factors of cardiac rehabilitation in patients after PCI, in order to provide scientific basis for doctors and nurses to formulate cardiac rehabilitation intervention strategies.Methods:A total of 146 patients after PCI were investigated with general data questionnaire and Cardiac Rehabilitation Inventory in the First Affiliated Hospital of Dalian Medical University from December 2019 to February 2020, and multiple linear regression was used to analyze the influencing factors of cardiac rehabilitation information demand.Results:The average scores of each dimension of Cardiac Rehabilitation Inventory after PCI were autonomy, process anxiety and result anxiety from high to low. Multiple linear regression showed that occupational type was a significant predictor of autonomy of patients after PCI, which could explain 4.6% of the variation of autonomy, and autonomy of in-service patients after PCI was higher than that of retirees ( t=2.81, P<0.05). Sex and age were significant predictors of process anxiety of patients after PCI, which could explain the variation of 8.6% of process anxiety. The occupational type, the medical insurance type and whether they had received professional rehabilitation guidance during hospitalization were significant predictors of anxiety after PCI, which could explain the 15.2% variation of anxiety, and the anxiety of in-service patients after PCI was lower than that of retirees ( t=-3.76, P<0.05). Conclusions:The level of cardiac rehabilitation information needs of patients after PCI is worthy of attention. Medical staff can give targeted, personalized and different forms of cardiac rehabilitation in the process of cardiac rehabilitation, and emphasize the implementation of health education and guidance for their cardiac rehabilitation in order to meet their cardiac rehabilitation information needs, improve their autonomy and alleviate their anxiety.