Objective To investigate the value of quantitative on analysis of argyrophil nucleolar organizer regions(AgNOR),carcinoembryonic antigen(CEA)and ferritin(Ft) for differentiation diagnosis of benign and malignant serous cavities effusion.Methods HPIAS-2000,a highly-clear image analysis system,was used to quantify 12 parameters of AgNOR particles of falling-off cells from 57 cases of benign and malignant serous cavities effusion.The shapes of AgNOR were observed and sorted.Meanwhile,CEA and Ft were examined with chemiluminescent assay.Results Among 12 parameters of AgNOR quantification,9 parameters were significantly distinct between benign and malignant serous cavity effusion(P

Objective: To investigate the specific cytotoxicities of the second and third generations of chimeric antigen receptor (CAR) -engineered T cells (CAR-T) on different lymphomas. Methods: CAR-Ts were prepared by lentivirus packaging and infection of T cells. CCK-8, ELISA and Lactate dehydrogenase cytotoxicity assay were applied to detect the proliferation capacity, the secretion level of inflammatory factor and the specific cytotoxicity. Flow cytometry assay showed the specific cytotoxicity and residual level of CAR-T in lymphomas of treated mice. Results: The results showed that the third generation CAR-T had greater capacity of the specific cytotoxicity and proliferation capacity than of the second generation CAR-T. But there was no prominent change of the secretion level of inflammatory factor. The specific cytotoxicity of the second generation CAR-T on highly aggressive lymphomas Raji was more prominent than in inert EHEB, but also could achieve satisfactory effect. The tumor burden in the mice injected with Raji was lower than in the mice injected with EHEB from nude mice experiment. But the residual level of CAR-T in the EHEB-injected mice was higher than in the Raji-injected ones. So the second generation CAR-T was more suitable for the treatment of indolent lymphoma. Conclusion The second generation CD19 CAR-T could treat aggressive lymphoma in a relatively short period, while the second generation CD19 CAR-T need a longer time in vivo to achieve satisfactory curative effect on the noble lymphoma.

Objective: To explore the clinical characteristics, diagnosis, treatment and prognosis of patients with hematological diseases that complicated by mucormycosis, and to improve the understanding and clinical diagnosis and treatment of the disease. Methods: The clinical data of 7 patients suffering from mucormycosis during September 2012 and September 2018 were retrospectively analyzed, and their clinical characteristics, treatment process and prognosis were analyzed. Results: Of 7 patients, there were 4 males and 3 females, with a median age of 36 (19-79) years old. Two patients were diagnosed as acute myeloid leukemia as the underlying disease, the other 5 patients suffered from acute B lymphoblastic leukemia, peripheral T cell lymphoma, chronic myelocytic leukemia in blastic phase, myeloproliferative neoplasm and severe aplastic anemia after transplantation, respectively. Among them, disease types of mucormycosis were pulmonary in 4 patients, rhino-orbital-cerebral in 1 patient, cutaneous in 1 patient and disseminated in 1 patient. All the cases were confirmed by biopsy histopathology. The treatment drugs were amphotericin B or liposomal amphotericin B, and posaconazole. Surgical treatment was performed in 4 patients, 3 out of 4 achieved radical debridement, and the other one had local debridement. Two patients were cured, 1 patient was improved and 4 patients died. Conclusions The clinical manifestation and image feature of mucormycosis in patients with hematological diseases were diverse, and the mortality rate is high, diagnosis mainly depends on histopathology. Early diagnosis, control of underlying disease, improvement of immunosuppressive status, timely effective antifungal therapy and radical surgical debridement are the key points for improving the survival rate of patients with hematological diseases complicated by mucormycosis.

Objective: To Evaluation the effect of PD-1 inhibitor Nivolumab on the proliferation and cytotoxicity of anti-CD19 chimeric antigen receptor T cells (CD19-CAR-T) in vitro. Methods: Five patients with high PD-1 expression in peripheral blood and five healthy volunteers were selected. These peripheral blood mononuclear cells were used as the source of T cells to prepare CD19-CAR-T cells. Different doses (72, 36, 18 μg/ml) of Nivolumab was added on day 8 to the culture medium. Patient T cells incubated with 72 μg/ml Nivolumab and CD19-CAR-T cells of healthy volunteers were used as controls. CCK-8, lactate dehydrogenase (LDH) cytotoxicity assay and ELASA were used to detect the proliferation capacity, the specific cytotoxicity and the inflammatory factor secretion. Results: ①T cells from patients with high expression of PD-1 as the source of CD19-CAR-T cells did not affect transfection rate compared with that of healthy volunteers [(32.80±7.22)% vs (35.10±5.84)%, t=-0.554, P=0.593]. ②Incubation of CD19-CAR-T cells with 72 μg/ml Nivolumab did not affect CD19-CAR-T cell proliferation, but its cytotoxicity was significantly higher than that of CD19-CAR-T cells alone or patients’ T cells +72 μg/ml Nivolumab (all P<0.001), there was no significant difference in the killing activity between the 72 μg/ml and 36 μg/ml Nivolumab treated CD19-CAR-T cells on Pfeiffer cells (P=0.281, 0.267, respectively), and they were all higher than those of 18 μg/ml Nivolumab treated CD19-CAR-T cells (all P<0.001). ③Different doses of PD-1 inhibitor Nivolumab combined with CD19-CAR-T cells does not affect the secretion of IFN-γ and IFN-α (all P>0.05). Conclusion Combination of 36 μg/ml PD-1 inhibitor and CD19-CAR-T cells could reduce the drug toxicity and enhance the cytotoxicity.

Objective: The aim of the study is to validate whether the Recognition Of Stroke In the Emergency Room (ROSIER) scale can be used by general practitioners (GPs) in an emergency medical service (EMS) protocol to transfer stroke patients from primary care center to advanced hospital with acute stroke center. Methods: GPs prospectively performed the ROSIER scale and the Cincinnati Prehospital Stroke Scale (CPSS) on suspected stroke patients as a transfer protocol. All patients were immediately transferred to the Level-II hospital for further treatment. Results: 468 of the 512 suspected stroke patients met the inclusion criteria in this study. The ROSIER scale showed a diagnostic sensitivity of 83.13% (95% confidence intervals [CI] 79.74-86.52%) and specificity of 80.88% (95% CI 77.32- 84.44%). The CPSS showed a diagnostic sensitivity of 78.01% (95% CI 74.26-81.76%) and specificity of 70.59% (95% CI 66.46-74.72%). The Kappa statistic value of the ROSIER scale and the CPSS were 0.601 and 0.454, respectively. The area under the curve (AUC) of ROSIER scale was large than the CPSS (AUC 0.855 vs. 0.791). However, the difference was not significantly different. Conclusions: This study suggest that ROSIER and CPSS could be used in an EMS protocol to transfer stroke patients from a primary care center to an advanced hospital offering thrombolysis service
Stroke

Objective To explore the relationship between gene polymorphisms of triggering receptor expressed on myeloid cells-1 ( TREM-1 ) rs2234237A/T, rs9471535A/G and susceptibility to coronary atherosclerotic heart disease ( coronary heart disease for short , CHD).Methods A case-control study.120 patients with CHD ( CHD group) and 90 healthy people (Normal control group ) were selected from November 2016 to April 2017 in Jingzhou Central Hospital.The single nucleotide polymorphisms (SNPs) of TREM-1gene (rs2234237 and rs9471535)were analyzed using Sanger method in all subjects. Comparing baseline clinical data and the distribution of genotype frequencies in the two groups .Non conditional logistic regression was used to analyze the relationship between TREM -1 gene ( rs2234237 and rs9471535) polymorphisms and susceptibility to CHD .Results The proportion of gender as well as level of age, body mass index, total cholesterol, triglyceride and low density lipoprotein cholesterol were not statistically significant between the two groups ( χ2＝0.575, P＞0.05; t＝-1.670, P＞0.05; t＝-1.719, P＞0.05; t＝1.011, P＞0.05; t＝-1.834, P＞0.05; t＝0.474, P＞0.05, respectively), while the proportion of smoking, hypertension and diabetes as well as level of high density lipoprotein cholesterol and fasting plasma glucose were statistically significant between the two groups (χ2＝4.321, P＜0.05; χ2＝39.213, P＜0.01; χ2＝24.184, P＜0.01; t＝5.476, P＜0.01; t＝-5.106, P＜0.01, respectively).The distribution of rs2234237, rs9471535 genotypes and alleles was statistically significant in the two groups (rs2234237: χ2＝6.893, P＜0.05; χ2＝7.159,P＜0.05, respectively; rs9471535: χ2＝8.284, P＜0.05; χ2＝8.314, P＜0.05, respectively).The genotype frequency of rs2234237(AT+TT)in CHD group was significantly lower than in the control group (38.3% vs 53.3%,χ2＝4.680, P＝0.031), and the genotype frequency of rs9471535 ( AG +GG) in CHD group was significantly lower than in the control group (37.5% vs 53.3%, χ2＝5.225, P＝0.022) .In addition, the T allele frequency of rs2234237 in CHD group was significantly lower than in the control group (21.7%vs 33.3%, χ2＝7.159, P＝0.007) , and the G allele frequency of rs9471535 in CHD group was significantly lower than in the control group(20.8%vs 33.3%, χ2＝8.314, P＝0.004).The CHD risk of people carrying rs2234237 TT was 0.173 times of AA (95% CI: 0.048 -0.629, P＝0.008), and the CHD risk of people carrying rs9471535 GG was 0.108 times of AA(95% CI: 0.026-0.450, P＝0.002).However, carriers with T allele of rs2234237(AT+TT) or with G allele of rs9471535(AG+GG)were not significantly associated with the CHD risk(P＞0.05).Conclusions TREM-1 gene rs2234237 A/T and rs9471535 A/G polymorphisms are significantly associated with susceptibility to CHD .rs2234237 TT genotype and rs9471535 GG genotype might act as protective factors of CHD.

Adult ; Anemia ; Female ; Humans ; Pancytopenia ; Pregnancy ; Pregnancy Complications, Hematologic ; Retrospective Studies ; Thrombocytopenia ; Young Adult