Objective To investigate the pathogenesis,clinical feature,laboratory examination characteristics and the prognosis of the bone marrow necrosis.Methods To analyze the clinical data of one case of diagnostic bone marrow necrosis and review the relevant literature.Results The peripheral blood examinations were as follows:the hemoglobin(HGB)level was 36g/L,platelet count was 17 ×109 /L.The biochemistry tests showed that lactate dehydro genase (LDH)was 1 454.9U /L and alkaline phosphatase(ALP)was 1 319.4U /L.Bone marrow necrosis was detected by bone marrow smear.Bone marrow biopsy was considered as a bone marrow metastatic carcinoma,which was prone to adenocarcinoma.Conclusion The bone marrow necrosis is mainly caused by the cancer,the serious infection and the drug.Its main performances were bone pain,fever,progressive decline in bloods cells,the LDH and ALP increasing and poor prognosis.In order to extend the lifetime of this kind of patients,the key lies in the early detection,the early diagnosis,and the early treatment of its primary diseases.

Objective To investigate the clinical and biochemical metabolic features of 12 patients with systemic primary carnitine deficiency(CDSP) and to identify the SLC22A5 gene mutation types of the disease. Method The clinical and biochemical data were collected by retrospective analysis. DNA direct sequencing and multiplex ligation dependent probe amplification(MLPA)were applied for SLC22A5 gene analysis. Result Among 12 patients with CDSP, 3 cases had evident infection factors, 6 cases with convulsions, 5 cases manifested liver hypertrophy, 8 cases with hyperammonemia, and 9 cases showed myocardial damage. All CDSP patients were detected biallelic pathogenic mutation in SLC22A5 gene by direct sequencing. The gene types include IVS2+1G>T, c.3G>T(p.Met1Ile), c.760C>T(p.Arg254X), c.1400C>G(p.Ser467Cys), c.844dupc(p.Arg282fs), c.338G>A(p.Cys113Tyr), c.51C>G(p.Phe17Leu), c.659A>T(p.Glu220Val), and c.1365dupC(p.Thr456fs). c.659A>T(p.Glu220Val) and c.1365dupC(p.Thr456fs)are novel mutations. One female patient was maternal CDSP, her child had abnormal newborn screening. The allele frequency of c.760C>T(p.Arg254X) and c.1400C>G(p.Ser467Cys) were 37.5%(9/24)and 29.2%(7/24)respectively. The MLPA test results of all patients were negative. Conclusion The clinical manifestations are complex and various in patients with CDSP. Point and small InDel(insertions/deletions)mutation constitute the major alteration in SLC22A5 gene. c.1400C>G(p.Ser467Cys) might be another prevalence mutation type in Chinese CDSP patient.

Objective: This study examined the impact of PRRSV NADC30-like strains on pig farms in Fujian, China. Methods: The effectiveness of strategic management protocols, including herd closure, medication programs, monitoring of processing fluids (pig testicular fluid), and collection of production data, were analyzed. The prevalent strain in the pig farm was identified as a NADC30-like strain of the PRRSV through genetic sequencing comparison analysis. Results: The quantitative real-time reverse-transcription polymerase chain reaction results showed that the PRRSV cycle threshold (Ct) values of the processing fluid samples were relatively low from September to early October 2021. After implementing the intervention measures (October 2021), the Ct value increased gradually and reached a negative in March 2022, lasting six months. In addition, the average survival rate of the pigs before the intervention was 84.1%, while the average survival rate after the intervention was 93.1%. Conclusions and Relevance: The use of 12-month intervals for pig herd closure, drug planning, and other strategic management agreements (multi-point production and active monitoring of production data, McREBEL) helped stabilize the subsequent pig farm production, providing a basis for clinical disease prevention and control.

Objective: This study examined the impact of PRRSV NADC30-like strains on pig farms in Fujian, China. Methods: The effectiveness of strategic management protocols, including herd closure, medication programs, monitoring of processing fluids (pig testicular fluid), and collection of production data, were analyzed. The prevalent strain in the pig farm was identified as a NADC30-like strain of the PRRSV through genetic sequencing comparison analysis. Results: The quantitative real-time reverse-transcription polymerase chain reaction results showed that the PRRSV cycle threshold (Ct) values of the processing fluid samples were relatively low from September to early October 2021. After implementing the intervention measures (October 2021), the Ct value increased gradually and reached a negative in March 2022, lasting six months. In addition, the average survival rate of the pigs before the intervention was 84.1%, while the average survival rate after the intervention was 93.1%. Conclusions and Relevance: The use of 12-month intervals for pig herd closure, drug planning, and other strategic management agreements (multi-point production and active monitoring of production data, McREBEL) helped stabilize the subsequent pig farm production, providing a basis for clinical disease prevention and control.

Objective: This study examined the impact of PRRSV NADC30-like strains on pig farms in Fujian, China. Methods: The effectiveness of strategic management protocols, including herd closure, medication programs, monitoring of processing fluids (pig testicular fluid), and collection of production data, were analyzed. The prevalent strain in the pig farm was identified as a NADC30-like strain of the PRRSV through genetic sequencing comparison analysis. Results: The quantitative real-time reverse-transcription polymerase chain reaction results showed that the PRRSV cycle threshold (Ct) values of the processing fluid samples were relatively low from September to early October 2021. After implementing the intervention measures (October 2021), the Ct value increased gradually and reached a negative in March 2022, lasting six months. In addition, the average survival rate of the pigs before the intervention was 84.1%, while the average survival rate after the intervention was 93.1%. Conclusions and Relevance: The use of 12-month intervals for pig herd closure, drug planning, and other strategic management agreements (multi-point production and active monitoring of production data, McREBEL) helped stabilize the subsequent pig farm production, providing a basis for clinical disease prevention and control.

Objective: This study examined the impact of PRRSV NADC30-like strains on pig farms in Fujian, China. Methods: The effectiveness of strategic management protocols, including herd closure, medication programs, monitoring of processing fluids (pig testicular fluid), and collection of production data, were analyzed. The prevalent strain in the pig farm was identified as a NADC30-like strain of the PRRSV through genetic sequencing comparison analysis. Results: The quantitative real-time reverse-transcription polymerase chain reaction results showed that the PRRSV cycle threshold (Ct) values of the processing fluid samples were relatively low from September to early October 2021. After implementing the intervention measures (October 2021), the Ct value increased gradually and reached a negative in March 2022, lasting six months. In addition, the average survival rate of the pigs before the intervention was 84.1%, while the average survival rate after the intervention was 93.1%. Conclusions and Relevance: The use of 12-month intervals for pig herd closure, drug planning, and other strategic management agreements (multi-point production and active monitoring of production data, McREBEL) helped stabilize the subsequent pig farm production, providing a basis for clinical disease prevention and control.

Objective To investigate the clinical characteristics and prognosis of chronic myeloid leukemia (CML) with the initial symptoms of intracranial space - occupying lesion. Methods The clinical features of a 49 years old CML female patient with the initial symptoms of intracranial occupying lesions in the Affiliated Hospital of Southwest Medical University were analyzed. And the literatures were reviewed and summarized. Results The main clinical manifestations of the patient were headache and blurred vision. Cranial CT showed space occupying lesions in the left frontal lobe. The white blood cell counts(WBC) was 360. 09 × 109/L. Bone marrow smear showed 87. 0％ of granulocyte and 13.5％ of primitive granulocytes,and the patient was diagnosed as CML(accelerated phase). The patient was treated with imatinib 600mg qd,and the disease was controlled. Her intracranial mass was disappeared, and achieved long-term disease-free survival. Imatinib on CML intracranial lesions also had certain curative effect. Conclusion Tyrosine kinase inhibitors(TKIs) should also be individualized for different patients. Dasatinib is the first choice for CML with intracranial occupying lesions. However, this case suggests that imatinib also has clinical efficacy. It may be related to the release of intracranial tumor cells into the peripheral blood or imatinib,and also a small amount of penetration through the blood-brain barrier. In the treatment of CML,appropriate TKIs should be chosen according to the patients'condition.

OBJECTIVE:To establish a method for the concentration determination of voriconazole in human plasma.METHODS:Plasma samples were precipitated with acetonitrile.Using ketoconazole as internal standard,HPLC method was adopted.The determination was performed on Dionex U-3000 Dimonsil C18 column with mobile phase consisted of triethylamine-glacial acetic acid-water mixed solution (1 ∶ 1∶98,V/V/V,pH was about 4.0)-acetonitrile (40∶60,V/V) at the flow rate of 1.0 mL/min.The detection wavelength was set at 255 nm.The column temperature was 40 ℃,and sample size was 20 μL.RESULTS:The linear range of voriconazole was 0.2-20.0 μg/mL.The limits of quantification was 0.2 μg/mL,and the minimum detection limit was 0.03 μg/mL.RSDs of inter-day and intra-day were lower than 10％.The method recoveries were 92.06％-106.26％ (RSD＜5％,n=5),and extraction recoveries were 75.62 ％-90.59 ％ (RSD ＜ 5 ％,n=5).The plasma concentration of voriconazole in 10 children ranged 0.22-4.90 μg/mL (n =10).CONCLUSIONS:The method is simple,rapid,specific and can be used for drug monitoring of voriconazole.

Objective To investigate the histone acetylation status of forkhead box P3(Foxp3)gene and its roles in immunological pathogenesis of Kawasaki disease(KD). Methods Forty - two children with KD and 32 age -matched healthy children consented to participate in this study as a control group. Co - immunoprecipitation and real -time PCR were performed to determine acetylation levels of histone H4 associated with Foxp3 gene and binding abilities of Kruppel like factor 10(KLF10)and p300 / CBP - associated factor (PCAF)with Foxp3 gene in CD4 + T cells. The proportion of CD4 + CD25 high Foxp3 + cells (Treg)and protein levels of Foxp3,KLF10,PCAF,phosphated SMAD family member 2 / 3(pSmad2 / 3)and itchy E3 ubiquitin protein ligase(Itch)were analyzed by flow cytometry. Quantitative real - time PCR was used to evaluate the levels of Foxp3,transforming growth factor - β1 receptor Ⅱ (TGF - βRⅡ), transforming growth factor - β1 receptor Ⅰ(TGF - βR Ⅰ),tyrosine kinase 2 (Tyk2),SH2 domain - containing protein - tyrosine phosphatase - 2(SHP2)and cytotoxic T - lymphocyte - associated protein 4 (CTLA4)mRNA in Treg. Plasma concentrations of TGF - β and interleukin - 6(IL - 6)were measured by enzyme - linked immunosorbent assay. Results (1)Compared with the control group,the proportion of Treg,expression levels of Foxp3 and TGF - β, and histone acetylation levels of Foxp3 promoter decreased remarkably during acute KD,and the differences were all statistically significant(all P < 0. 05),and restored after IVIG therapy(all P < 0. 05). Meanwhile,the 5 indexes afore-mentioned in KD patients with coronary artery lesions (KD - CAL +)were lower than those without coronary artery le-sions(KD - CAL -),and the differences were all statistically significant (all P < 0. 05). (2)Compared with the control group,protein levels of KLF10 and PCAF in Treg cells,and their binding abilities with Foxp3 gene were significantly down - regulated during acute KD,and the differences were all statistically significant(all P < 0. 05),and restored to some extent after IVIG treatment(all P < 0. 05). Positive correlations between protein levels of KLF10 and PCAF,and mRNA level of Foxp3 were detected in acute KD patients (r = 0. 47,0. 59,all P < 0. 05). Furthermore,protein levels of KLF10 and PCAF and their binding abilities with Foxp3 gene in KD - CAL + group were lower than those in KD -CAL - group,and the differences were all statistically significant(all P < 0. 05). (3)Compared with the control group, the plasma concentration of TGF - β and expressions of TGF - βRⅡ/ Ⅰ,pSmad2 / 3,Itch,CTLA4 and SHP2 in Treg were down - regulated during the acute phase of KD,and the differences were all statistically significant(all P < 0. 05), as well as plasma concentration of IL - 6 and expression its downstream molecule Tyk2 increased remarkably in patients with acute KD(all P < 0. 05). All the indexes mentioned before restored significantly after IVIG treatment (all P <0. 05). Simultaneously,the 7 former indexes in KD - CAL + group were found to be lower than those in KD - CAL -group,while 2 indexes of the latter in KD - CAL + group were higher than those in KD - CAL - group,and the differ-ences were all statistically significant(all P < 0. 05). Conclusion Histone hypoacetylation of Foxp3 promoter might be one of the important factors contributing to insufficiency and dysfunction of regulatory T cells during acute Kawasaki dis-ease.

Objective To deepen the understanding of curative effect and adverse drug reaction of brentuximab vedotin in the treatment of Hodgkin's lymphoma.Methods One case of newly diagnosed Hodgkin's lymphoma who treated with brentuximab vedotin was collected.The clinical features,laboratory examination,treatment procedure,prognosis were analyzed,and the relevant literature was reviewed.Results The patient was twenty years old,female,found the right neck masses for five days,diagnosed with Hodgkin's lymphoma,mixed cell type,stage Ⅳ group B.Chose the chemotherapy regimen BV + GABVD for 4 courses,the PET-CT indicated CR,then used GABVD 4 courses,now in the stage of clinical observation and followed up.Conclusion BV is a kind of antibody-drug conjugate which targeted on CD30 protein.The FDA approved for the treatment of Hodgkin's lymphoma and systemic anaplastic large cell lymphoma.The common adverse reactions are granulocyte,peripheral neuropathy,fatigue,nausea and vomiting.BV can significantly improve the prognosis of CD30 positive Hodgkin's lymphoma,but need to pay attention to the prevention of adverse reactions.