Objective To evaluate the effects of pegylated interferon plus ribavirin on naive and retreated chronic hepatitis C (CHC) patients.Methods A total of 67 CHC patients were divided into naive group (n =35) and retreat group (n =32) based on their treatment history.And their virological responses [rapid virological response (RVR),early virological response (EVR),virological response to etravirine (ETR) and sustained virological response (SVR)] and risk factors were analyzed.Results ①RVR and EVR of naive group were 60％ (n =21) and 77％ (n =27),respectively,and the retreat group were 28％ (n =9),53％ (n =17).The differences between the two groups were significant (both P ＜ 0.05).On the contrary,CHC patients in both groups might achieve similar ETR and SVR rates (P ＞ 0.05) ; ② The relapse rate in the retreat group was higher than that in the naive group (22％ vs.10％).But the differences had no statistical significance (P ＞ 0.05) ; ③ CHC patients in the retreat group could achieve similar responses,including RVR,EVR,ETR and SVR (P ＞ 0.05) whether treated previously with standard interferon or pegylated interferon; ④ According to muhivariable logistic regression analysis,the retreated genotype 1 CHC patients has a lower SVR rate compared with naive genotype non-1 counterparts (OR =0.29 and 0.26,all P ＜ 0.05).Conclusions CHC patients in the naive group could achieve higher virological responses and a lower relapse rate compared to those in the retreat group.The previous treatment regimeu has no significant effect on virological responses of CHC patients retreated with Peg-IFN plus ribavirin.Genotype 1 and retreatment are both risk factors of achieving SVR.

Objective To evaluate the relationships of the serum levels of matrix metalloproteinase-9 (MMP-9), intercellular adhesion molecule-1 (ICAM-1) and adiponectin with the mild cognitive impairment (MCI) in senile metabolic syndrome (MS)patients. Methods The 74 cases with MS and 30 health controls (control group) were enrolled. Mini-mental state examination (MMSE), montreal cognitive assessment (MoCA), digit-symbol test (DST), auditory verbal memory test (AVMT), trail making test(TMT), sunderland clock drawing test (CDT) and verbal fluency test (VFT) were applied to evaluate cognitive function. Based on the cognitive assessment, MS patients were divided into two groups: 39 cases with MCI (MS+MCI group) and 35 cases without cognitive impairment (MS group). The levels of MMP-9, ICAM-1 and adiponectin were measured by ELISA. Biochemical variables were measured by routine methods in all subjects. Results (1)MS+MCI group showed the higher levels of BMI, SBP, FBG and MMP-9 (all P＜0.05) and lower level of adiponectin (P＜0.05) than did the MS group. And MS group had higher levels of MMP-9 and ICAM-1 (P＜0.01) and lower adiponectin level (P＜0.01) than did the control group. (2)Spearman's correlation analysis showed that the serum levels of MMP-9 (r=-0.794, P＜0.001) and ICAM-l (r=-0.501, P＜0.001) were negatively correlated with adiponectin. However, MMP-9 was positively correlated with ICAM-1 (r=0.481, P=0.006). (3)Multiple linear regression analysis indicated that there was linear relationship of MoCA with MMP-9 (β=-3.438, P=0.0019), adiponectin (β=1.337, P=0.006), SBP (β=-0.058, P=0.003) and FBG (β=-0.227, P=0.049). (4)Stepwise logistic analysis showed that both high MMP-9 (OR=1.007) and low adiponectin (OR=0.359) were risk factors for the decline of cognitive function. Conclusions Elderly patients with MS may show deterioration in memory, calculation and visuospatial perception. Elevated inflammatory factors might contribute, in combination with abnormal metabolism, to MCI. MMP-9 might contribute to neuronal degeneration. However, adiponectin could strongly counteract the risk factors for cognitive impairment.

Objective To analyze biomechanical differences among quantity configurations of four common cannulated screws using three-dimensional finite element analysis.Methods The Dicom CT images of the right proximal femoral neck of a 65-year-old Chinese healthy volunteer were used to establish models of three kinds of different Pauwels types of femoral neck and four kinds of different quantity and configuration models (triangle,inverted triangle,rectangle,diamond) through three-dimensional virtual softwares.Models were imported into the finite element analysis software Ansys.After axial load application,the stress and displacement on the screws and femoral head were compared.The peak stresses on the screws,peak stresses on the femoral head break side and displacement peaks were observed.Results Four kinds of quantity and configuration models (triangle,inverted triangle,rectangle,rhombus) had different peak stress on the screws and femoral head break side and different displacement peak.Among Pauwels type Ⅰ fractures,the peak stresses on the screws were 46.382,32.159,43.985,and 24.342 MPa;the peak stresses on the femoral head break side were 5.840,7.440,3.731,and 6.311 MPa;the displacement peaks were 0.610,0.608,0.598,and 0.595 mm.Among Pauwels type Ⅱ fractures,the peak stresses on the screws were 46.763,39.979,49.619,and 25.692 MPa;the peak stresses on the femoral head break side were 4.971,7.332,3.161,and 5.734 MPa;the displacement peaks were 0.634,0.635,0.622,and 0.631 mm.Among Pauwels type Ⅲ fractures,the peak stresses on the screws were 51.432,39.477,51.515,and 26.949 MPa,and the peak stresses on the femoral head break side were 6.163,10.070,5.257,and 9.552 Mpa;the displacement peaks were 0.662,0.654,0.644,and 0.644 mm.Conclusion The fixation of femoral neck fractures with four screws in a diamond position can guide clinical application,for the procedure has better stress dispersion effects,ensure fracture stablility,provide effective sliding compression and anti-torsion and have biomechanical advantages.

Lung cancer is one of the most malignant tumors in the world. In China, the mortality rate of lung cancer has been in the first place for many years. Early screening and early diagnosis of lung cancer is the premise of prolonging the survival time of patients with lung cancer. In recent years, liquid biopsy technology, which is considered to have a bright future, has attracted more and more attention, and its value in the early diagnosis of lung cancer is worth discussing. This paper reviews the application of biomarkers in early screening and early diagnosis of lung cancer, looks for specific biomarkers from multi-omics, and discusses their significance in early diagnosis of lung cancer.

Lung cancer is one of the most common cancers worldwide, and its mortality rate remains high. In addition to conventional surgery, radiotherapy, and chemotherapy, immunotherapy methods have been developed and used in recent years for the treatment of non-small cell lung cancer (NSCLC). However, only a small number of patients with NSCLC can benefit from immunotherapy strategies, and some patients even have hyperprogression after receiving immunotherapy. Therefore, precision immunotherapy requires effective biomarkers to guide it. In this paper, tissue samples, blood samples, intestinal microbiota, and other biomarkers are reviewed according to different sample sources. Blood samples, including TCR immune repertoire, Tregs cells, cytokines, lactate dehydrogenase, and other markers, are summarized and analyzed to provide reference for clinicians' diagnosis and treatment decisions.

Primary central nervous system lymphoma (PCNSL) is a rare extranodal aggressive non-Hodgkin lymphoma (NHL) that differs from other NHL in terms of morbidity, diagnosis, and treatment. PCNSL accounts for 1%-6% of all central nervous system tumors, and 4%-6% of extranodal lymphomas. The incidence of PCNSL has increased gradually in the past 10 years, from 0.15/100 000 to 0.48/100 000. The pathological diagnosis is the only method for definite diagnosis. Stereotactic puncture is the currently preferred invasive procedure. Magnetic resonance imaging is the gold standard for diagnosis and follow-up of PCNSL. The chemotherapy based on large doses of methotrexate (≥3 g/m2) is currently the main treatment. For patients who are suitable for autologous hematopoietic stem cell transplantation, autologous transplantation can improve the short-term and long-term survival. New drug treatment and clinical research are encouraged for patients with relapsed and refractory PCNSL. This review will briefly introduce the current status and progress in treatment of PCNSL.

Objective: Chronic graft-versus-host disease (cGVHD) is a major long-term complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . It is important to study the changes of serum biomarkers expression in patients for early diagnosis and treatment. Methods: The expression levels of five serum protein markers (IL-1b, IL-16, CXCL9, CCL19, CCL17) in patients with or without cGVHD after allo-HSCT were detected by liquid suspension microarray. Results: Compared with the control group without cGVHD, the expression levels of CXCL9 and CCL17 in serum of patients with cGVHD were significantly increased (P<0.05) . CCL17 was correlated with the severity of cGVHD (P<0.001) . CXCL9 was significantly increased in the serum of patients with skin lesion (P<0.01) , and CCL17 was significantly expressed in cGVHD patients with liver as the target organ (P<0.01) . Conclusion The combination of CXCL9 and CCL17 can be used as serum biomarkers of cGVHD, which has certain reference value in assisting the diagnosis and evaluation of cGVHD severity.

Objective:To explore the effect of artificial intelligence teaching-picture system in training the bone marrow cell morphological reading ability of clinical medical students.Methods:A total of 110 five-year undergraduate students were divided into experimental group (artificial intelligence picture teaching method) and control group (traditional teaching method) in the bone marrow cell morphology reading ability training. On the basis of multimedia teaching, the experimental group was given the teaching by using the bone marrow cell morphology picture storage and transmission system for retrieval, learning and computer adaptive test. Then objective evaluation of image recognition ability and questionnaire were used to compare the teaching effect.Results:The image recognition ability was significantly better in the experimental group than in the control group [(89.6±5.7) vs. (81.4±4.9), P<0.01]. Furthermore, the experimental group showed more obvious advantages in cell morphology recognition [(74.7±4.0) vs. (68.7±4.9)] and diagnosis of hematological diseases [(14.9±3.0) vs. (12.9±2.4)] than the control group (both P<0.01). Questionnaire survey showed that the students expressed their affirmation and support for the artificial intelligence teaching-picture system in the bone marrow cell morphological reading ability training. Conclusion:The application of artificial intelligence teaching-picture system can greatly improve the teaching effect, mobilize students' learning enthusiasm and expand learning resources, which is worthy of further promotion and application.

The clinical research model based on evidence - based medicine (EBM) can effectively improve students' learning initiative, cultivate their abilities to obtain information and solve problems, and strengthen their scientific and innovative thinking in clinical research. Moreover, the EBM-based clinical research model can also help supervisors to update knowledge system and maintain strong clinical innovative thinking and research ability. The EBM - based clinical research model was applied in the cultivation of postgraduate students in hematology, and through topic selection, new technique application, ethical number acquisition, registration of clinical research number, case enrollment, and statistical analysis, postgraduates can master the methods and process of clinical research, which lays a solid foundation for future research.

OBJECTIVETo study the blocking effect of CXCR4 inhibitor AMD3100 on the adhesion of leukemia cells to osteoblast niche, and the reversal of multidrug resistance in leukemia cells.

METHODSMesenchymal stem cells (MSCs) from leukemia patients were planted on the bio-derived bone scaffolds and then induced into osteoblasts to establish the bio-osteoblast niche. The levels of SDF-1were tested with ELISA. The leukemia cell line MV4-11 cells with FLT3-ITD mutation were inoculated into the bio-osteoblast niche to build a three-dimensional co- culture system. The expression level of CXCR4, adhesion and apoptosis rates of leukemia cells were observed by flow cytometry after incubation with AMD3100 and Ara-C for 24 h and 48 h.

RESULTS(1)The supernatant levels of SDF-1 in cultured osteoblast were (304 ± 18), (410 ± 28) and (396 ± 16) pg/ml on 7 th, 14 th and 21 th day, respectively. It reached the highest on 14 th day. The expression level of CXCR4 in cultured MV4-11 cells was (72 ± 16)%. (2)Adhesion rate of MV4-11 cells to osteoblast niche was (40.1 ± 8.1)% after AMD3100 treatment for 24 h, while that of control group was (65.6 ± 12.1)% (P<0.05). (3)The apoptosis rate of MV4-11 cells incubated with AMD3100 for 24 h was (5.6 ± 0.8)%, while that of control group was (2.5 ± 0.5)%. The apoptosis rates of AMD3100-induced MV4-11 cells were (10.0 ± 2.4)%, (17.8 ± 2.3)% and (25.1 ± 2.4)% after treatment with Ara-C at 0.02, 0.20, 2.00 mg/ml respectively and they were (6.7 ± 1.0)%, (10.3 ± 1.5)%, (16.2 ± 3.1)% respectively in AMD3100-noninduced control group, the difference was significant (P<0.05).

CONCLUSIONAMD3100 can block the interaction between osteoblasts niches and leukemia cells, and play an important role in the reversal of multidrug resistance in leukemia cells.

Apoptosis ; Cell Adhesion ; Cell Line, Tumor ; Chemokine CXCL12 ; Coculture Techniques ; Cytarabine ; Drug Resistance ; Flow Cytometry ; Heterocyclic Compounds ; Humans ; Leukemia ; Mesenchymal Stromal Cells ; Osteoblasts ; Receptors, CXCR4 ; Signal Transduction