0.05). No adverse reations occurred. Conclusion: Yinghuajiedu Granules is safe and effective for influenza with wind heat type.

Objective To detect the expression of dead box 1(DDX1)gene in tumor tissue and pericarcino-matous tissue of clinical neuroblastoma(NB)samples,and explore the relationship between DDX1 and NB. Methods Five cases of pathological specimens in children with NB were chosen from Department of Pathology,the First Affi-liated Hospital of Xinxiang Medical University between January 2012 and December 2014. In the 5 cases,3 cases were male,2 cases were female,the age of 1 - 5 years old,average age(2. 1 ± 1. 6)years. The NB tissue and pericarcino-matous tissue(pericarcinomatous tissue was normal tissue which was at least 2 cm from the tumor tissue)of 5 children were collected and fixed in 40 g/ L formaldehyde solution. Then with the conventional dehydration,embedding,sectio-ning, dewaxing, hydration, antigen repair, add primary antibodies, secondary antibodies, diaminobenzine chromogenic. The expressions of DDX1 in tumor tissue and pericarcinomatous were observed with light microscopy and with semi - quantitative analysis.(1)Staining degree:no staining with 0 score;light staining with 1 score;medium staining with 2 scores;deeply staining with 3 scores.(2)Positive cells proportion:positive cells proportion ﹤ 10% with 0 score;positive cells proportion within 10% - 30% with 1 score;positive cells proportion within 31% - 60% with 2 scores;positive cells proportion ﹥ 61% with 3 scores. Final scores were a half of the sum of staining degree score and positive cells proportion score,final score within 0 -1. 0 with - ,1. 1 -2. 0 with + ,2. 1 - 3. 0 with + + ,3. 1 -5. 0 with + + + . Results DDX1 were expressed in NB and pericarcinomatous tissues,but visible DDX1 positive staining number more and deeper in NB,DDX1 positive staining number less and light in pericarcinomatous tissues. Five cases of pericarcinomatous tissues immunohistochemical semi - quantitative score were negative and final scores were 1. 0 score or less,the mean value was 0. 5 score. NB immunohistochemical semi - quantitative score were+or + +and final scores were 1. 5 score or higher,the mean value was 1. 8 scores,the expressions of DDX1 were sig-nificantly higher in NB than the pericarcinomatous tissues. Conclusions DDX1 is highly expressed in NB,which may contribute to the development of NB. This suggest DDX1 may serve as an oncogene and play a catalytic role in the de-velopment of NB,which provides a clinical evidence for the follow - up study.

Objective To explore the influence of icotinib in the apoptosis of the human salivary adenoid cystic carcinoma cells ACC-M, and to clarify the mechanism of icotinib for the treatment of salivary adenoid cystic carcinoma.Methods The ACC-M cells were randomly divided into control group,2,4,8μmo1·L-1 icotinib groups,p38-MAPK inhibitor SB203580 (20μmol· L-1 )group,SB203580 (20 μmol· L-1 )+4μmo1 · L-1 icotinib group;the cells were collected 4 h after treatment.The viability of ACC-M cells was measured by MTT assay.The apoptosis of ACC-M cells was assessed by caspase-3 activity kit. The expression of p-p38-MAPK protein was determined by Western blotting analysis.Results Compared with control group,the inhibitory rates of growth of the ACC-M cells in icotinib groups were significantly decreased (P<0.05 ), and the activities of caspase-3 were increased (P<0.05),and the expression levels of p-p38-MAPK were significantly increased (P<0.05).Compared with 4μmo1·L-1 icotinib group,the expression level of p-p38-MAPK in SB203580+icotinib group were decreased (P < 0.05 ), and the activity of caspase-3 was decreased dramatically (P < 0.05 ). Conclusion Icotinib may induce the apoptosis of ACC-M cells through the activation of p38-MAPK signaling pathway.

Objective To study the clinicopathologic features and prognosis factor of Chinese lymphoblastic lymphoma.Methods 105 LBL cases were collected.Routine HE staining,immunostaining were used to investigate the clinicopathologic features,immunotype.Results The ratio of male to female was 1.76:1 (67:38),the medial age was 13 years old (0-73 years old).53 cases (53/105,50.48 ％) primarily showed lymph node involvement,including 34 cases (34/53,64.15 ％) showed jugular node involvement;mediastinum (12/52,23.08 ％) was the most frequent extranodal involvement site.69 cases (69/105,65.71％)showed bone marrow involvement with 15 cases as the primary involvement.The expression of TdT,CD99,CD3(E),CD20,CD79a,PAX5,MPO,CD34 and CD117 was 84.76 ％ (89/105),85.00 ％ (68/80),54.37 ％ (56/103),16.67 ％ (16/96),40.00 ％ (8/20),46.67 ％ (28/60),14.29 ％ (8/56),25.00 ％ (4/16) and 0.All cases were divided in to two groups,62 cases as T-LBL (59.05 ％,62/105) and 33 cases as B-LBL (31.43 ％,33/105),with 9 cases (8.57 ％,9/105) without the expression of T or B cell marker and 1 cases with the expression of both T and B cell marker.61 cases were detected the expression of myeloid markers and 8 cases were positive.All cases were followed up.The medial survival was 36 months.The survival at 1 year,2 year and 3 year was 66.67 ％ (70/105),48.81％ (41/84) and 20.69 ％ (12/58) respectively.Age was the prognosis associated factor.The children had better progonosis than adults.Immunotype,bone marrow involovement and transplantation didn' t show prognosis indicator (P ＞ 0.05).Conclusion Most of Chinese LBL occurs in child and younger male,multi-lymphadehypertrophy and bone marrow involvement are common.LBL is an aggressive tumor.Age is the prognosis associated factor.Children have a better prognosis than the adult.

OBJECTIVETo evaluate the correlation between MicroRNA-191 (miR-191) and T lymphoblastic leukemia/lymphoma (T-ALL/LBL) to probe its underlying molecular mechanism.

METHODSThe expression of miR-191 was examined by real-time PCR (RT-PCR) in 20 T-ALL/LBL tissue samples and 20 lymphoid reactive hyperplasia (LRH) tissue samples. The correlation between miR-191 and the clinicopathological feature of T-ALL/LBL was analyzed. Antisense miR-191 lentiviral vectors was constructed and transfected into T-ALL/LBL Jukat cells. After transfection, the expression of miR-191 was examined by RT-PCR. The cell activity was evaluated by CCK-8 asssy. The cell cycle and apoptosis were determined by flow cytometry.

RESULTSCompared with LRH samples, the results of RT-PCR showed significant upregulation of miR-191 in 20 T-ALL/LBL tissue samples (1.875±0.079 vs 1.000, P<0.05). The expression level of miR-191 was negatively associated with prognosis. Compared with LV-NC-GFP and control groups, the expression of miR-191 significantly decreased after transfection of antisense miR-191 lentiviral vectors (0.578±0.012 vs 1.011±0.053 and 1.000, P<0.05), the percentages of apoptotic cells and the cell in G0/G1 phase significantly increased (P<0.05).

CONCLUSIONSmiR-191 might play a significant role in the development of T-ALL/LBL, implicating a new target for therapy.

Apoptosis ; Cell Cycle ; Flow Cytometry ; Humans ; Lentivirus ; MicroRNAs ; genetics ; metabolism ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; metabolism ; Prognosis ; Real-Time Polymerase Chain Reaction ; Transfection

Objective To compare the efficacy and safety of Iamivudine-interferon sequential therapy and lamivudine monotherapy in HBeAg-positive chronic hepatitis B (CHB) patients.MethodsA total of 172 patients with HBeAg-positive CHB were randomized to sequential group (n=83) or lamivudine group (n=89).Sequential group were administrated with lamivudine 100 mg/d and 5 million units interferon alpha 2b subcutaneous injection every other day for 24 weeks were added since week 25 of treatment.Lamivudine group were administrated with lamivudine 100 mg/d for 48 weeks.All subjects were followed up for 24 weeks after drug withdrawal.Measurement data with homogeneity of variance were analyzed by using t test and data with heterogeneity of variance were analyzed by using rank sum test.The comparison of rates was done by chi square test or Fisher exact test.ResultsThe baseline hepatitis B virus (HBV) DNA levels of patients in sequential group and lamivudine group were (7.8±1.0) and (7.9±1.1) lg copy/mL,respectively (P＞0.05),and the baseline alanine aminotransferase (ALT) levels were (210.5 ± 150.1 ) and (211.9 ± 160.9) U/L,respectively (P＞0.05).At the end of treatment,higher ALT levels [(78.4±146.1) vs (36.1±32.4) U/L,P＜0.05)] and HBV DNA levels [(4.5±1.5) vs (3.8±1.3) lg copy/mL,P＜0.05)] levels,lower response rates (65.8％ vs 83.5％,P＜0.05),and similar HBeAg loss rates (31.6％ vs 22.2％,P＞0.05) and HBeAg seroconversion rates (27.6％ vs 16.0％,P＞0.05) were found in sequential group compared with lamivudine group.At the end of follow-up,higher ALT levels [(126.0±143.1) vs (82.7±83.0) U/L,P＜0.05)],similar HBV DNA levels [(5.3±1.5) vs (5.0±1.5) lg copy/mL,P＞0.05)],similar HBeAg loss rates (25.0％ vs 32.3％,P＞0.05) and HBeAg seroconversion rates (25.0 ％ vs 26.2 ％,P＞0.05) were found in sequential group compared with lamivudine group.YMDD motif mutation rate in sequential group was lower than lamivudine group at week 48 of treatment (10.5％ vs 26.9％,P＜0.05).ConclusionsLamivudine-interferon sequential therapy and lamivudine monotherapy are both effective in HBeAg-positive CHB patients,while HBV mutations are reduced in patients with sequential therapy.

Objective:To explore the influential factors for hospitalization costs regarding the final phase of malignant tumor patients in Shanghai,and to explore the relevant policy for reasonable control of hospitalization costs.Methods:A total of 10 065 patients with malignant tumors were enrolled in this study.The multiple linear regression analysis was used to seek the determinants for hospitalization cost of malignant tumor patients during the final phase.Results:The median length of hospital stay was 43 days for the patients,with an average age of (70.73±12.87) years.Among them 61.66％ of hospitalized patients were male and the median hospitalization cost of malignancy was 55 447.84 yuan.Hospitalization cost showed the linear regression relationship with type of health care,hospital level,hospital types,tumor types,length of hospital stay,surgery,age,gender,and time from hospital admission to death.Conclusion:Proximity to death in malignant tumor patients is an important factor for the hospitalization cost.Medical resources should be allocated rationally,and the comprehensive measures should be taken to control the cost reasonably.

OBJECTIVETo study the clinicopathological characteristics and prognostic factors in Chinese patients with primary intestinal non-Hodgkin's lymphomas (PINHL).

METHODSThe clinical symptoms, pathological features, diagnostic and prognostic factors of 273 cases diagnosed with PINHL from our center were analyzed.

RESULTSAmong 273 cases, 189 were male and 84 female, the male to female ratio was 2.3:1. The age of patients ranged from 2 to 85 years old with the median age of 46. The most frequent site of the lesions was ileocecus (n=83, 30.4%). The clinical symptoms of PINHL were unspecific with abdominal mass frequently seen in B-cell lymphoma, and perforation, hypogastric pain and "B" symptoms more common in T-cell lymphoma. Endoscopic biopsy diagnosis rate was 90.3%. Of 273 cases, B-cell lymphoma (n=232, 85.0%) dominated PINHL with the most common subtype of diffuse large B-cell lymphoma-not otherwise specified (DLBCL-NOS) (n=132, 48.4%), while the T-cell lymphoma (n=41, 15.0%) were much less seen with the most common subtype of enteropathy-associated T-cell lymphoma (EATL) (n=15, 36.6%). There were 245 cases were followed up, including 206 cases of B-cell lymphoma and 39 cases of T-cell lymphoma, it was found that the prognosis of B-cell lymphoma is much better than that of T-cell lymphoma (P<0.05). Operation had no significant effect for the overall survival rate. But for patients with aggressive lymphoma, operation can improve the survival rate.

CONCLUSIONIt indicates that PINHL often occurs as B cell type, DLBCL-NOS is the most common histological type. Ileocecus is the most common site involved and enteroscope biopsy is a good method of diagnosis. Compared with T-cell lymphoma, B-cell lymphoma has different clinical manifestations and a better prognosis. Patients with aggressive lymphoma can benefit from operation.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Intestinal Neoplasms ; pathology ; Lymphoma, Non-Hodgkin ; pathology ; Male ; Middle Aged ; Prognosis ; Young Adult

Objective:To investigate the correlation of monocyte/lymphocyte ratio (MLR) with the prognosis and adverse event in critically ill patients.Methods:Basic information of patients were extracted from Medical Information Mart for Intensive Care-Ⅲ (MIMIC-Ⅲ), including demographics, blood routine, biochemical indexes, systemic inflammatory response syndrome score (SIRS), sequential organ failure assessment (SOFA) score, and outcome, etc. MLR on the first day of intensive care unit (ICU) admission was calculated. The receiver operating characteristic curve (ROC curve) was applied to evaluate the prognostic value of MLR on the 30-day mortality and its cut-off value. According to the cut-off value, the patients were divided into two groups, and the differences between the groups were compared. Logistic regression model was used to analyze the relationship of MLR with 30-day mortality, continuous renal replacement therapy (CRRT), mechanical ventilation, the length of ICU stay, and total hospitalization time.Results:① A total of 43 174 critically ill patients were included. ROC curve showed that area under ROC curve (AUC) of MLR in predicting 30-day mortality was 0.655 [95% confidence interval (95% CI) was 0.632-0.687]. The cut-off value of MLR calculated according to the maximum Yoden index was 0.5. There were 16 948 patients with MLR ≥ 0.5 (high MLR group) and 26 226 patients with MLR < 0.5 (low MLR group). ② Compared with the low MLR group, the high MLR group had higher age, proportion of male, body mass index (BMI) [age (years old): 66.0 (51.7, 78.4) vs. 57.6 (27.1, 74.6), proportion of male: 57.2% vs. 52.5%, BMI (kg/m 2): 26.5 (22.5, 31.1) vs. 24.7 (14.3, 29.7)]. The high MLR group also had higher incidence of complications (hypertension: 49.2% vs. 44.6%, chronic heart failure: 32.6% vs. 21.7%, diabetes mellitus: 27.0% vs. 23.4%, chronic obstructive pulmonary disease: 21.5% vs. 16.1%, renal insufficiency: 19.3% vs. 13.1%), and higher white blood cell count (WBC), blood glucose, lactate (Lac), serum creatinine (SCr), SIRS score and SOFA score [WBC (×10 9/L): 13.8 (9.6, 19.2) vs. 11.5 (8.4, 15.6), blood glucose (mmol/L): 8.66 (6.88, 11.49) vs. 8.27 (6.55, 10.88), Lac (mmol/L): 2.2 (1.5, 3.7) vs. 2.1 (1.4, 3.3), SCr (μmol/L): 106.1 (70.7, 176.8) vs. 88.4 (70.7, 132.6), SIRS score: 3 (2, 4) vs. 2 (2, 3), SOFA score: 4 (2, 7) vs. 3 (1, 5)]. The 30-day mortality, and the proportion of patients with length of ICU stay > 5 days, total hospitalization time > 14 days, CRRT and mechanical ventilation > 5 days were significantly higher in high MLR group (30-day mortality: 20.0% vs. 8.3%, length of ICU stay > 5 days: 33.2% vs. 20.4%, total hospitalization time > 14 days: 33.7% vs. 16.2%, CRRT: 3.6% vs. 0.7%, mechanical ventilation > 5 days: 18.4% vs. 5.7%), with statistically significant differences (all P < 0.05). ③ After adjusted with the related factors, multivariate Logistic regression analysis showed that elevated MLR was an independent risk factor for increased 30-day mortality [odd ratio ( OR) = 1.54, 95% CI was 1.37-1.72, P < 0.001]. Moreover, the increased MLR was independently associated with the increased risk of usage of CRRT ( OR = 2.77, 95% CI was 2.18-3.51), mechanical ventilation > 5 days ( OR = 2.45, 95% CI was 2.21-2.72), the length of ICU stay > 5 days ( OR = 2.29, 95% CI was 2.10-2.49), and total hospitalization time > 14 days ( OR = 2.28, 95% CI was 2.08-2.49), all P < 0.001. Conclusions:Retrospective analysis of large sample shows that MLR elevation is an independent risk factor for 30-day mortality, usage of CRRT, prolonged mechanical ventilation time, prolonged hospitalization, prolonged length of ICU stay. MLR can be used for risk stratification of severe patients.

Hepatitis B virus (HBV) infection is a common cause of liver disease in China, and with the continuous progress in the research on antiviral therapy for chronic hepatitis B, the indications for antiviral therapy are constantly expanding. However, there are still controversies over the indications for antiviral therapy in patients with chronic hepatitis B (CHB), especially those with negative HBV. By analyzing the limitations of HBV DNA detection, the risk of HBV reactivation in HBV-negative CHB patients, the risk of disease progression in the DNA-negative population with compensated hepatitis B cirrhosis, antiviral response, and the economic benefits of antiviral therapy, this article proposes the necessity of antiviral therapy for HBV-negative HBsAg-positive patients with compensated hepatitis B cirrhosis.