Objective:To study the effect and influence factor analysis of DLBCL patient with early stage who receive radiotherapy after chemotherapy.Methods: 374 cases of patients with DLBCL was selected from January 2010 to December 2015 in our hospital. By random number table method, the patients were divided into CHOP group (n=104), R-CHOP+RT group (n=93), R-CHOP group (n=80), CHOP+RT group (n=97). CHOP chemotherapy was given to all patients, 180 patients received radiotherapy after chemotherapy, and 169 patients received rituximab. Survival rates were compared between the 4 groups.Results: The survival rate of R-CHOP group in 12 months, 24 months, 50 months and 100 months were lower than R-CHOP+RT group, but the difference was not statistically significant in twelfth months(x2=2.02,P>0.05). The differences of 24 months, 50 months and 100 months were statistically significant (x2=4.08,x2=4.03,x2=8.79;P<0.05); The survival rate of CHOP group was 12 months and 24 months was higher than CHOP+RT group which the difference was not statistically significant (x2=1.05,x2=0.22;P>0.05); The survival rate of CHOP group in 50 months and 100th months was lower than CHOP+RT, but the difference was no significant difference (x2=1.62,x2=0.03;P>0.05). Smoking index, whether the use of rituximab, the age associated with the survival of patients, the difference was statistically significant.Conclusion: Early DLBCL patients with R-CHOP and radiotherapy combined treatment can be effective in patients with survival, while the use of rituximab chemotherapy, in addition to smoking on the prognosis of patients with serious adverse effects.

Objective To research the applicable ways on training and examination of defibrillator utilization in grassroots units. Methods The use of the "three-step training and two-part examination" mode, that is, three-step training(theoretical instruction, grouped practice and animal experiment), a total of 83 medical officers from inferior troops of PLA were trained for the use of defibrillators, and through passing two-part test(written test and skill test), the trainees were subsequently examined so that the efficacy of the training could be evaluated. Results The trainees can be acquired satisfying achievement in the two-part test after having passed the three-step training. The respectively average scores were 86.7 ?15.9 (written test) and 90.1?14.8 (skill test). Conclusion The "three-step training and two-part test" mode is a successful defib- rillators' training mode for inferior troops.

OBJECTIVE:To observe the effectiveness and safety of different doses of rosuvastatin in the treatment of acute ce-rebral infarction. METHODS:Totally 120 patients with acute cerebral infarction were selected from Weifang Yidu Central Hospital during Jan. 2014-Dec. 2015,and then divided into observation group and control group according to admission order,with 60 cas-es in each group. Both groups received routine treatment as Shuxuening injection 10 mL,iv,1-2 times a day(or 20 mL added into 5% Glucose injection 250-500 mL,ivgtt,qd)+Aspirin enteric-coated tablets 0.1 g,po,qd. Control group and observation group were additionally given Rosuvastatin calcium tablets 10 mg and 20 mg,po,qd(after supper). Both groups were treated for 30 d. The levels of serum inflammatory factors(hs-CRP,TNF-α,IL-6),blood lipid indexes(TC,TG,LDL-C),neurological function and activity of daily life score were observed in 2 groups before and after treatment. The clinical efficacy and occurrence of ADR were recorded. RESULTS:Before treatment,there was no statistical significance in the levels of hs-CRP,TNF-α,IL-6,TC,TG and LDL-C,NIHSS scores and Barthel index (BI) scores between 2 groups (P>0.05). After treatment,the levels of hs-CRP, TNF-α,IL-6,TC,TG and LDL-C,NIHSS scores in 2 groups were decreased significantly,while BI scores were decreased signifi-cantly,observation group were significantly better than those of control group,with statistical significance (P<0.05). Total re-sponse rate of observation group (93.33%) was significantly higher than that of control group (86.67%),with statistical signifi-cance (P<0.05). The incidence of ADR in observation group (23.33%) was significantly higher than control group (6.67%), with statistical significance(P<0.05). CONCLUSIONS:Rosuvastatin can significantly reduce the inflammatory reaction and blood lipid level of patients with acute cerebral infarction,inhibit the formation of atherosclerotic plaque and improve prognosis. The large dose of rosuvastatin have better efficacy for acute cerebral infarction and can significantly improve the symptom of neurologi-cal deficits and daily living ability of patients.

Asthma ; physiopathology ; Child ; Female ; Humans ; Male ; Maximal Expiratory Flow-Volume Curves ; Oscillometry ; methods ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; Respiratory Function Tests

Objective To study the expression of Toll-like receptor 4(TLR4) in peripheral blood mononuclear cell (PBMCs) and serum interleukin-6(IL-6) in wheezing children under 5 years of age.Methods A total of 224 wheezing children under 5 years of age were divided into API(asthma predictive index)-positive (n=116) and API-negative groups (n=108).Serum level of IL-6 and TLR4 expression on CD14+ monocytes were measured after wheezing was stable for one month.TLR4 expression on CD14+ monoeytes was quantified via flow-cytometry.Serum level of IL-6 was detected by ELISA.Results Serum level of IL-6 and TLR4 expression on CD14+ monocytes of API-positive group were higher than API-negative group [LR4(％):34.9±10.0 vs.30.2± 8.8;IL-6(ng/L):46.4±15.1 vs.40.5±13.6].There was a significant positive correlation between the expression of TLR4 and the content of serum IL-6 in two groups of wheezing children(P＜0.05).Conclusion TLR4 may play a role in the pathogenesis of asthma through promoting the expression of IL-6.TLR4 may be a index to predicting asthma in wheezing children.

OBJECTIVE:To prepare Hyaluronic acid-methyl collagen-terpolymer (HEMA-MMA-MAA)/Doxorubicin com-pound membranes-loaded tantalum stent,and to optimize the formulation. METHODS:Electrostatic self-assembly reaction was ad-opted to prepare compound membranes using metal tantalum stent as carrier,hyaluronic acid,methyl collagen and terpolymer as ex-cipients. With 1 and 30 d accumulative release rate as index,orthogonal test was used to optimize mass concentrations of hyaluron-ic acid,methyl collagen and terpolymer,and validated. The drug release behavior in vitro were investigated. RESULTS:The opti-mal formulation was as hyaluronic acid 1 mg/ml,methyl collagen 4.5 mg/ml and terpolymer 100 mg/ml. 1 and 30 d accumulative release rates of prepared tantalum stent were 7.57%(RSD=2.3%,n=3) and 84.14%(RSD=2.1%,n=3),respectively. 20 d later,dissolution rate approximated to zero level rate of drug release. CONCLUSIONS:Hyaluronic acid-methyl collagen-terpoly-mer/Doxorubicin compound membranes-loaded tantalum stent with sustained-release property is prepared successfully.

Objective To investigate the technique and clinical results of total hip arthroplasty in treating post-traumatic hip fusion ankylosis secondary to operation in acetabular combined with femoral head fracture.Methods From October 2009 to January 2015,7 patients (7 hips) with post-traumatic hip fusion ankylosis underwent total hip arthroplasty.There were 6 males and 1 female with an average age of 38 years (range,25-51 years).There were 4 hips on the left side,3 hips on the right side.Open reduction and internal fixation were performed on all patients.One patient had a postoperative deep infection and 6 patients underwent implant removal.The hip bony fusion ankylosis was developed secondary to post-traumatic arthritis after the surgery of ipsilateral acetabular combined with femoral head facture.The interval between internal fixation and total hip arthroplasty was 37.6 months on average (range,21-67 months).The hip bony fusion ankylosis was relieved by wedge shape osteotomy at femoral neck level.The cemenfless prostheses were implanted in suitable places based on the accuracy position of acetabular center.One infection case was treated via surgical debridement,removal of all the screws,and antibiotic-loaded cement spacer implantation in the first stage.The cementless prostheses were implanted in the second stage.Results The average operation time and blood loss was 108 min (90-150 min) and 320 ml (280-450 ml) respectively.The internal fixation devices were explanted completely,including plate and screw in 5 cases,only screw in 1 case,intramedullary nail and screw in 1 case.The mean fallow-up period was 32.5 months (range,15-48 months).The average Harris hip score improved from 48.8±6.5 points preoperatively to 92.6±5.1 points post-operatively (t=22.82,P=0.001).Osseointegration was developed in all of the acetabular and femoral components at 3 months post-operatively.Radiograph analysis showed satisfied position of acetabular cup and no evidence of implant migration or center of rotation change.Stem subsidence (＜1.0 mm) occurred in 2 cases and heterotopic ossification in 2 cases (Brooker type Ⅰ and type Ⅱ in 1 case,respectively) at one year postoperatively.No complication occurred,such as damages of vessels and nerve,dislocation,component loosening or infection.Conclusion The wedge shape osteotomy of femoral neck is a safe and reliable method in treating hip fusion ankylosis.Total hip arthroplasty can be achieved by reconstruction of acetabular center,suitable components implanted in anatomical position and ideal reconstruction of soft tissue around hip.

Objective To discuss the method and clinical effect of bilobed DIEP flap for repair of degloving injuries of the hand.Methods From June, 2013 to January, 2015, the bilobed DIEP flap were designed to repair 6 cases of degloving injuries of hand, of which the small leaf flap repaired separately defect of thumb, larger leaf flap repair 2nd-5th finger and palm and dorsum.The bilobed DIEP flap design were based upon anatomic study on deep inferior epigastric artery, superior epigastric artery, intercostal artery and its anastomosis.Results The largest area of main flap was 35 cm × 12 cm, and the deputy leaves of flap was 10 cm× 7 cm.All of the 6 flaps survived.One of them experienced distal end necrosis of epidermis.But it was healed by dressing changes.All of the 6 cases were followed up for average of 12 months (range, 6-20 months).All flaps were seen with good appearance, fully recovered protectve sensation and the active motion of the thumb was recovery.Moreover, the donor sites were closed directly and the appearance were satisfactory.Conclusion The bilobed DIEP flap is a satisfying choice in repairing degloving injuries of the hand in that it has reliable blood supply, can obtain the larger area of skin and leaves small injuries in targeted area.

Objective To discuss the clinical application and evaluate the effect of repairing finger injuries using the perforator flap in forearm cubital fossa.Methods From July,2012 to December,2013,8 cases of finger injuries with totaled defect area of 2.5 cm × 4.0 cm-5.5 cm × 7.0 cm were reviewed.Among them,6 cases had phalangeal fracture,7 cases had neurovascular injury and 4 cases combined with tendon injuries.Cubital fossa flaps based on the inferior cubital perforator of radial artery were transplanted to repair the defects.Results All of the 8 flaps survived.One of them experienced distal end necrosis of epidermis and 1 cm long wound dehiscence.But it was healed by dressing change.All of the 8 cases were followed up for an average of 11 months (range,6-20 months).Sensory quality of （S） + was present in all of the flaps with two-point discrimination ranging between 7.5 mm and 9.8 mm with an average of 8.5 mm.All flaps were seen with good appearance,texture and colour.Moreover,function and appearance in donor sites were satisfactory.Conclusion The perforator flap in forearm cubital fossa is a satisfying choice in repairing small skin defects in fingers and other paas in that it is fixed,easy to dissect and leaves small injuries in targeted area.

Aim To investigate the effects of leptin on ?1(Ⅰ) collagen mRNA expression and protein production, and the roles of Janus kinase/signal transducers and activators transcription(JAK/STAT) signaling transduction pathway in increased ?1(Ⅰ) collagen mRNA expression stimulated by leptin in activated hepatic stellate cells(HSCs).Methods Firstly, ?1(Ⅰ) collagen mRNA expression and protein production as well as JAK1 and STAT3 phosphorylation induced by leptin at different doses in a human HSC cell line, LX-2 were determined by RT-PCR, ELISA, and Western-blot.Secondly, the effects of JAK1 inhibitor AG490 on JAK1 phosphorylation and ?1(Ⅰ) collagen mRNA expression stimulated by leptin were detected by Western blot and RT-PCR. Thirdly, the roles of AG490 and transfection with STAT3 antisense oligonucleotide(STAT3-ASON) in STAT3 phosphorylation after leptin were detected by Western blot. Finally, the effect of transfection with STAT3-ASON on ?1(Ⅰ) collagen mRNA expression after leptin was measured by RT-PCR.Results Leptin increased ?1(Ⅰ) collagen mRNA expression and protein production in a dose-dependent manner in LX-2, reaching a maximal level at 80 ?g?L-1 leptin. In addition, phosphorylation of JAK1 and STAT3 after leptin exhibited a time-dependent effect. Besides, JAK1 inhibitor AG490 completely blocked JAK1 and STAT3 phosphorylation and increased in ?1(Ⅰ) collagen gene expression after leptin in LX-2. Transfection with STAT3-ASON blocked STAT3 phosphorylation and increased ?1(Ⅰ) collagen mRNA by leptin in LX-2.Conclusion Leptin had a direct action on liver fibrogenesis by stimulating ?1(Ⅰ) collagen mRNA expression and protein production in activated HSC, and JAK/STAT signaling transduction pathway was involved in the process. JAK1 inhibitor AG490 and transfection with STAT3-ASON blocked the transduction pathway effectively in LX-2. Leptin may be an important factor in the development of hepatic fibrosis. Activated JAK1 and STAT3 signaling in human HSC line provided a novel molecular target for therapeutic intervention of liver fibrosis.