Short course chemotherapy combined with local field radiotherapy (IFRT) is an important treatment for limited-stage (Ⅰ -Ⅱ)diffuse large B cell lymphoma patients,but the value of radiotherapy has been disputed.Some patients may be cured by combined chemotherapy which contains anthracycline,but there are some patients still facing death.Therefore,researchers try to improve survival of patients further by increasing the density or intensity of the chemotherapy dose,but attempt to reduce the dose or the use of low toxicity drugs for elderly patients.In addition,researches such as radioimmunotherapy and biological targeted therapy have made certain progress.

Objective To investigate the correlation of CYP2D6 gene polymorphism and serum tamoxifen (TAM) and its active metabolites (4-hydroxy tamoxifen,4-OH-TAM) in terms of prognosis of breast cancer patients.Methods The oral mucosas and serum were obtained from 200 breast cancer patients receiving oral TAM from Jan 2008 to Oct 2010.Real-time RT-PCR was used to determine CYP2D6* 10 gene polymorphism.The relationship between CYP2D6* 10 gene polymorphism and clinicopathological features and prognosis was assessed by Chi-square test and Cox proportional model.Serum TAM and 4-OH-TAM concentration were determined by liquid chromatography-trap mass spectrometry (LC-MS).Results Of 200 breast cancer patients,CYP2D6 * 10/* 10 homozygotes were found in 94 cases (47％),CYP2D6 wt/wt wild type in 48 cases (24％) and CYP2D6 wt/* 10 heterozygote in 58 cases (29％).The concentration of serum 4-OH-TAM in patients with CYP2D6 wt/wt wild type and wt/* 10 heterozygote was significantly higher than that in patients with CYP2D6 * 10/ * 10 homozygote (F =4.31,P =0.01).CYP2D6 gene polymorphism was not related to clinicopathological features (P ＞ 0.05).Logrank test showed that patient's disease-free survival with mutational CYP2D6 (mean,47.2 months) was significantly shorter than that in patients without mutational CYP2D6 (mean,51.2 months) (P =0.018).Cox proportional model showed that CYP2D6 genotype was related to disease-free survival (HR =2.755,95％CI:1.230 ～6.173,P =0.014).Conclusions CYP2D6 *10/* 10 genotype is related to curative effect of TAM on breast cancer patients,detection of CYP2D6 * 10/* 10 genotype helps improve the choice of TAM therapy.

Objectives To explore the changes of serum interleukin-33 (IL-33), IgA anti-endothelial cell antibodies (AECA) and IgA anticardiolipin antibodies (ACA) in acute stage of Henoch-Sch?nlein purpura (HSP) in children and its clinical signiif-cance. Methods Thirty-seven children with acute HSP admitted to hospital were selected from Nov.2012 to Jan.2013. Twenty healthy children were selected as healthy controls. The serum levels of IL-33 were measured by double anti-body sandwich en-zyme-linked immunosorbent assay (ELISA) and the serum levels of AECA-IgA and ACA-IgA were detected by double antigen sandwich ELISA. Results Serum levels of IL-33, AECA-IgA and ACA-IgA in patients with acute HSP were signiifcantly higher than those in healthy controls (P<0.001). According to different clinical types, the serum levels of IL-33, AECA-IgA and ACA-IgA were signiifcantly higher in mixed-type HSP (with joint involvement and gastrointestinal symptoms and/or kidney damage) than those in HSP patients with only joint, abdomen or renal involvement (P<0.05). Serum levels of IL-33 in acute stage of HSP had a positive correlation with AECA-IgA (r=0.752, P<0.001) and ACA-IgA (r=0.788, P<0.001). Conclusions The immune pathological injury in vessels caused by the interaction of IL-33, AECA-IgA and ACA-IgA may be the important pathogenesis of HSP, which may provide a clue for the early diagnosis and treatment for HSP.

Objective To study the relation between the quantity of DNA extracted by Chelex-100 method and multiplex STRs analysis.Methods DNA extracted from a variety of common forensic casework specimens were quantified by using Real-time PCR,and then amplified with AmpFLSTR IdentifilerTM PCR Amplification kit.ResultsAccording to the results of quantification,the quantities of DNA extracted from 113 samples by Chelex-100 method were adjusted to 0.5~3ng for establishing 8?l amplification system,and in this condition,most of 113 forensic casework specimens could be successfully genotyped.Conclusion When the quantity of DNA extracted by Chelex-100 method ranged from 0.5ng to 3ng,most results of multiplex STRs analysis were satisfying.Moreover,the amplification effect of 1?l DNA template was better than 3?l DNA template when the concentrations of extracted DNA were more than 0.5ng/?l.

0.05).Conclusion:It suggests that HPDLFs exposured to static magnetic field produced by magnetic attachment have little mutagenic effects on chromosomes and DNA.

Objective To analyze the clinical features of Hashimoto thyroiditis with thyroid cancer, and provide scientific basis for clinical diagnosis and treatment. Methods The clinical data of 87 patients of Hashimoto thyroiditis with thyroid cancer and 105 patients of Hashimoto thyroiditis were retrospectively analyzed. Results The rates of Hashimoto thyroiditis with thyroid cancer in age <30, 30-39, 40-49, 50-59 and≥60 years were 1/3, 47.5%(29/61), 51.4%(38/74), 36.0%(18/50) and 1/4. The rates of Hashimoto thyroiditis with thyroid cancer in patients of age 30-39 years and 40-49 years were higher than that in patients of age ≥60 years, but there were no statistical differences (χ2=0.327 and 0.418, P>0.05). There were statistical differences in total thyroxine (TT4), thyroid stimulating hormone (TSH), thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) levels between Hashimoto thyroiditis with thyroid cancer and Hashimoto thyroiditis, there were statistical differences (P<0.05 or <0.01). Multiariable Logistic regression analysis result showed that the decreased serum level of TT4 and the increased levels of TSH, TgAb and TPOAb were the correlated factors of Hashimoto thyroiditis with thyroid cancer (P<0.05 or <0.01). Conclusions Low level of TT4 and high levels of TSH, TgAb and TPOAb may increase the risk of Hashimoto thyroiditis with thyroid cancer. The 30-49 years male patients with Hashimoto thyroiditis should be highly suspected of the possibility of merger thyroid cancer.

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease of the central nervous system that is characterized by inflammatory demyelinating lesions and axonal degeneration in optic nerve and spinal cord. It has high relapse rate and high disability rate. In recent years, as the studies on mechanisms of NMOSD, related immune therapy strategies have been developed rapidly. These immunologic interventions are collectively called the disease modifying therapy, which are helpful in improving the course and outcome of the disease. In this review, the latest treatment progress in NMOSD is summarized to guide clinical choice and application of the medication.

Objective To investigate the clinical application of parenteral nutrition drugs and promote the rational use of drugs.Methods The data of parenteral nutrition drugs used in our hospital were analyzed,including the quantity,the amount of money,the scope and purpose,etc.The rationality of drug use was reviewed by prescription comment simultaneously.Results On similar medicines comparison,the fat emulsion,amino acids (17) and glucose (11％) injection (1440mL) and fat emulsion and amino acids (18) injection (1 000mL),which were designed according to the basal metabolic rate in patients were far greater than the fat emulsion,amino acids(17) and glucose (11％) injection (1 920mL) of the added value of design.And the balanced amino acid preparations in compound amino acid in 18 AA-Ⅳ usage,was far greater than 18 AA-Ⅱ and 18 AA.Fat emulsion preparation with concentration of 20％ dosage was bigger,because the price advantage,ordinary long-chain fat milk consumption was greater than the long chain fatty milk.In terms of drug use rationality,the usage,dosage,compatibility and adverse reactions of parenteral nutrition drugs were analyzed.The dosage,frequency and compatibility problems still needed to be improved.Conclusion The use of parenteral nutrition drugs were basic reasonable,but we should strictly control the indications for parenteral nutrition support,such as drug compatibility,using frequency to strengthen management and reasonable application of drugs to improve medication safety.

Objective To investigate the effects of ropivavaine on gamma -aminobutyric acid(GABA)-activated membrane cur-rents in isolated dorsal root ganglion(DRG) neurons of the rats with ischiadic nerve chronic constriction injury (CCI) and to discuss the possible analgesia mechanism of ropivacaine .Methods The whole-cell patch clamp technique was used to record and compare the changes of GABA receptor activation currents of acute isolated DRG neurons after 30 s of ropivacaine preperfusion in the oper-ating side and the operative opposite side of the CCI model rats and the sham-operation group .Results (1)Compared with the oper-ative opposite side ,the sham-operation group and the control group ,the thermal withdrawal latency in the operative side group of the CCI model rats was notablely shortened(P<0 .05);(2)the amplitude of GABA-activated currents with different concentration GABA(0 .1-1 000μmol/L) in the operative opposite side group of the CCI operation was significantly greater than that of the op-erative side group and the sham-opeartion group ;(3)DRG neurons after ropivacaine preperfusion (0 .1-1 000μmol /L) showed va-rying degrees of enhancement effect on the 100 μmol/L GABA-activated currents ,the enhancement amplitude in the CCI operative opposite side group was significantly greater than that in the operative side group and the sham-operation group ;(4)The dose-re-sponse curve of DRG neurons GABA (0 .1-1 000μmol/L) activated current in the operative side group of the CCI rats after ropiva-caine pre-perfusion (100 μmol/L) was shifted to the left ,the difference between two EC50 had no statistical significance (P>0 .05) .Conclusion Ropivacaine has the enhancement effect on GABA activated currents in the DRG neurons of the CCI model rats , which could be one of reasons for ropivacaine producing the anesthetic and analgesic effect .

Objective In order to verify the validation of the industry standard WS/T 405‐2012 about adult blood cell analysis reference range ,and ensuring their clinical application .Methods According to Clinical and Laboratory Standards Institute(CLSI) C28‐A3 recommendation method ,40 health reference individuals were enrolled in the study whose blood samples were collected ,de‐tected and analyzed .Results The blood cell analysis indicators involved in the validation included WBC ,RBC ,hemoglobin(HGB) , hematocrit(HCT) ,mean corpuscular volume(MCV) ,mean corpuscular hemoglobin(MCH) ,mean corpuscular hemoglobin concen‐tration(MCHC) ,platelet(PLT ) ,etc .The probability of all results of selected 40 reference individuals beyond the WS/T 405‐2012 blood cell analysis reference interval were no more than 10% (value 90% or higher) .Conclusion The WS/T 405‐2012 blood cell a‐nalysis reference range is suitable for the laboratory .A perfective verification system should be established to ensure its application .