In order to meet the requirements of medical teaching contents and curriculum system reform, we adopt the experience ofHarvard University School of Medicine to integrate Biochemistry and Cell Biology into a new one—— "Chemistry and Biology of theCell". We have carried out the integration of the two courses three times. In this new course, repeated contents have been reduced, thelinkage of the two courses has been increased, and the burden of students was lightened,which makes students contact the clinic earlierand enables to improve the students' ability to solve problems.

OBJECTIVETo investigate the expression of programmed death-1 (PD-1) and programmed death ligand-1(PD-L1) in peripheral T-lymphocytes from patients with chronic periodontitis and its significance and to clarify its role in the development of chronic periodontitis.

METHODSA total of 73 subjects were included in the study and divided into three groups, chronic periodontitis(30 cases), chronic gingivitis(25 cases) and 18 healthy controls. The peripheral blood was collected and PD-1/PD-L1 expression in the surface of CD(+)4 T lymphocytes and CD(+)8 T lymphocytes was examined by flow cytometry. Blood samples from 16 chronic periodontitis patients were collected at week 0 and 6 after initial therapy for 6 weeks and PD-1 and PD-L1 expression in the surface of CD(+)4 and CD(+)8 T lymphocytes was also determined by flow cytometry. The data were statistically analyzed.

RESULTSThe percentage of PD-1 expression in CD(+)4 and CD(+)8 T lymphocytes of chronic periodontitis group[(16.7 ± 5.5)%,(20.8 ± 5.1)%]and chronic gingivitis group[(14.2 ± 6.1)%,(14.5 ± 4.3)%]were higher than that of healthy controls[(9.5 ± 2.1)%, (8.1 ± 1.9)%](P < 0.05). The percentage of PD-L1 expression in CD(+)4 and CD(+)8 T lymphocytes of chronic periodontitis group[(24.2 ± 7.1)%,(15.3 ± 6.8)%]and chronic gingivitis group[(12.4 ± 6.0)%,(11.2 ± 5.5)%]were higher than that of healthy controls[(4.7 ± 1.2)%, (3.2 ± 2.3)%] (P < 0.05). The percentage of PD-1/PD-L1 expression in CD(+)4 T lymphocytes and CD(+)8 T lymphocytes of the chronic periodontitis group were significantly decreased after initial therapy(P < 0.05).

CONCLUSIONSThe expression of PD-1 and PD-L1 in peripheral CD(+)4 T lymphocytes and CD(+)8 T lymphocyte of chronic periodontitis patients was up-regulated and was associated with periodontal condition. The initial therapy reduced the expression of PD-1 and PD-L1.

B7-H1 Antigen ; biosynthesis ; Case-Control Studies ; Chronic Periodontitis ; immunology ; metabolism ; Flow Cytometry ; Humans ; Programmed Cell Death 1 Receptor ; biosynthesis ; T-Lymphocytes ; Up-Regulation

Objective:To investigate the efficacy and safety of zanubrutinib combined regimens for treatment of elderly patients with central nervous system lymphoma (CNSL).Methods:The clinical data of 3 elderly patients with CNSL who received zanubrutinib combined regimens from July 2020 to March 2022 in the Affiliated Suzhou Hospital of Nanjing Medical University were retrospectively analyzed. Two of them were primary central nervous system lymphoma (PCNSL) and one was secondary central nervous system lymphoma (SCNSL). Relevant literature was reviewed at the same time.Results:The two patients with PCNSL were treated with zanubrutinib in combination with rituximab and lenalidomide (Z-R 2) regimen. One of them achieved complete remission (CR) after 6 cycles, and the other patient achieved partial remission (PR) after 1 cycle of Z-R 2 regimen. The patient with SCNSL was diagnosed with diffuse large B-cell lymphoma (DLBCL) previously and suffered from central nervous system relapse after achieving CR. The patient achieved PR after 2 cycles of Z-R 2 regimen, and then achieved CR followed by 4 cycles of zanubrutinib in combination with rituximab and high-dose methotrexate (Z-R-HD-MTX) regimen. Two of the three patients were still in CR until April 2022, and the longest disease-free survival time was 15 months. There were no severe adverse reactions during the treatment. Conclusions:Zanubrutinib combined regimens for 3 elderly patients with CNSL have shown promising effect and well tolerance, which may be considered as novel treatment for CNSL patients who are unable to tolerate severe chemotherapies or autologous hematopoietic stem cell transplantations.