The prognosis of elderly (>60 years) patients with diffuse large B-cell lymphoma (DLBCL) is significantly worse compared with young patients, and there is currently no standard treatment. Elderly patients with DLBCL are highly heterogeneous, a stratification before treatment can help achieve precise medicine and improve outcome of them. R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin and prednisolone) is still the recommended treatment for fit elderly DLBCL patients; and for unfit or very old patients, chemotherapy of reduced dose or palliative treatments should be considered. Choices for relapsed or refractory patients are limited, and novel compounds or therapies that are well tolerated may have a good application prospect.

Aim To explore the correlationship of allergy to penicillin and HLA-DRB genetic polymorphism.Methods Sequence specific primer-polymerase chain reaction(PCR-SSP)was used to type for human leucocyte antigen-DBR(HLA-DRB)alleles in 77 patients with allergy to penicillin and 87 healthy subjects without any allergic reactions.Results Compared with control subjects,a significantly increased frequency of DR9 was present in 77 patients with allergic reactions(11.04% vs 4.02%,RR=3.24,P

Acute Disease ; Autonomic Nervous System Diseases ; Child ; Humans ; Male

Objective To explore the correlation of anti-ganglioside antibodies with clinical features of systemic lupus erythematosus (SLE). Methods Samples of serum were collected from 48 patients with SLE. Three were male and 45 were female. Their average age was 33±12 (15～59). The serum anti-ganglioside antibodies of 10 patients with rheumatoid arthritis (RA), 4 with Sj(o)gren's syndrome (SS), 1 patient with mixed connective tissue disease (MCTD), 1 with polymyositis (PM), and 97 healthy controls(HC) were alsoexamined. Levels of anti-GM1-IgM/IgG, anti-GQ1b-IgM/IgG antibodies in the serum were examined by amodified ELISA. Anti-dsDNA-IgG antibody of SLE was tested according to the ELISA kit protocol. The associations of anti-GM1-IgM/IgG and anti-GQ1b-IgM/IgG antibodies with clinical features were analyzed. x2test, one-way ANOVA, Dunnett t-test were used for statistical analysis. Results By using modified ELISA,the upper limit of reference value of anti-GM1-IgM/IgG antibodies, anti -GQ1b-IgM/IgG antibodies in the serum of Chinese SLE patients were 0.411, 0.408, 0.481 and 0.441 res-pectively. 19% patients with SLE were sero-positive for anti-GM1 antibody, 4% for IgM antibody isotype and 15% for IgG antibody isotype. Anti-GM1-IgG antibody was significantly increased in the serum of patients with SLE (0.33±0.09), higher than that of the HC (0.27±0.05) (P<0.05), RA (0.29±0.08), SS(0.27±0.06), PM ( 0.288 ), but one of the MCTD( 0.423 ).There was no significant associations between anti-GM1-IgM/IgG, anti-GQ1b-IgM/IgG antibodies and NPSLE and anti-dsDNA-IgG antibody (P>0.05). Conclusion Peripheral autoimmune response against GM1 can be detected in SLE patients, and it may be involved in the pathogenesis of SLE. No association of antiGM1-IgM/IgG antibodies or anti-GQ1b-IgM/IgG antibodies with clinical features of SLE can be discovered.

Hilar cholangiocarcinoma is a common bile duct cancer.The radical resection rate of end-stage malignancies reported in literature is about 20％.Half of the patients have lost the chance of operation at the time of care,while the average survival time in the patients who can not be operated is about six months.Therefore,for most patients,looking for a palliative treatment which can prolong the survival time is particularly important.From June 2013 to June 2014,our hospital applied iodine-125 brachytherapy,to treat 7 patients with unresectable hilar cholangio carcinoma.All the patients are still alive,the average survival time of 7 patients is 5.2 months up to now,with median survival time being 7.8 months,and longest survival time being 12 months.With good outcomes,few complications,as well as significantly prolonged survival time,iodine125 brachytherapy is regarded with broad clinical applications.

AIM: To provide experimental evidence for gene therapy of thrombophilia disease, we constructed the eukaryotic expression plasmid with human thrombomodulin (hTM) gene and observed the alteration of hTM expression on the surface of human umbilical vein endothelial cells (HUVECs) with and without the reconstructive plasmid. METHODS: The whole expressive fragment of hTM gene was amplified by PCR from human genome. Both hTM gene and pcDNA3.1(+)/neo empty vector was digested by HindⅢ and EcoRⅠ. Two digested fragments were ligated into pcDNA3.1/hTM with T_4DNA ligase. After identifying, the reconstructive plasmid transfected into HUVECs using lipofectin. The hTM antigen on the HUVECs was detected by immunohistochemistry. RESULTS: The hTM reconstructive plasmid was confirmed by double endonuclease redigesting and sequencing. About 10% HUVECs were transfected by pcDNA3.1/hTM plasmid with lipofectin and the high-level hTM was detected on the transfected cells. CONCLUSION: We constructed the pcDNA3.1/hTM plasmid successfully, and it could be expressed on the HUVECs. [

Objective: To explore the contribution of cytochrome P450 (CYP) 1A1z.ast;2C polymorphism to susceptibility to acute lymphoblastic leukemia (ALL) in children. Methods: The case-control studies involving the association of CYP1A1z.ast;2C polymorphism with the susceptibility to childhood ALL were retrieved through computer-based search in PubMed, Embase, Ovid, China Journal Full-text Database, Chinese Biomedical Literature Data, China National Knowledge Infrastructure and Wanfang Database. The statistical analysis was performed by STATA 12.0 software. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated, and the subgroup ananlysis, sensitivity analysis and publication bias were also carried out. Results: A total of seven eligible case-control studies were included for analysis. The Meta analysis revealed that there was a significant association of CYP1A1z.ast;2C ploymorphism with risk of childhood ALL (C vs A: OR = 1.20, 95% CI: 1.01-1.43; GG vs AA: OR = 1.73, 95% CI: 1.1 1-2.70; GG vs AG + AA: OR = 1.68, 95% CI: 1.09-2.59). In a subgroup in which the controls were hospitalized in the same period as the cases hospitalized, there was also a significant association of CYP1A1z.ast;2C ploymorphism with risk of childhood ALL (G vs A: OR = 1.29, 95% CI: 1.04-1.59; GG vs AA: OR = 1.89, 95% CI: 1.15-3.10; GG vs AG+AA: OR = 1.83, 95% CI: 1.14-2.94). After excluding a study with high heterogeneity, the sensitivity analysis showed no significant association between CKP1A1z.ast;2C ploymorphism and childhood ALL. Conclusion: The results of this Meta analysis suggest that CYP1A1z.ast;2C polymorphism may be not significantly associated with the susceptibility to childhood ALL.

In order to survey antibiotic resistance of clinical isolates carbapenem-resistant A cinetobacter baumannii in Meizhou and to investigate resistance mechanism and molecular epidemiological characteristics ,a total of 210 non-duplicated clinical isolates of carbapenem-resistant Acinetobacter baumannii from January 2012 to December 2012 were collected .The K-B disk diffusion method was applied for the drug-susceptibility test ,a modified Hodge test was used for the screening of carbapen-emase ,PCR was used to amplify carbapenemase genes (including IMP ,VIM ,OXA-23 ,OXA-24 ,OXA-51 and OXA-58) ,and the positive products were sequenced .Enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) was used for DNA typing and test of homology .Our results on the percentage of strains resistant for antibiotics tested were higher than 60% except for polymyxin B was 0 .48% .There were 163 positive strains by the modified Hodge test ,accounting for 77 .62% .OXA-51 gene was identified in 198 strains (94 .29% ) ,OXA-23 in 165 strains (78 .57% ) ,and VIM in 9 strains (4 .29% ) ,OXA-24 ,OXA-58 and IMP gene was not identified by PCR amplification .Seven genomic types were included in the 210 carbapenem-resistant Acinetobacter baumannii .The major prevalence types were Type A (97 strains) ,Type B (44 strains) and Type H (25 strains) . In conclusion ,multiple drug resistance of clinically isolated carbapenem-resistant A cinetobacter baumannii is a serious problem in Meizhou .Production of OXA-51 ,OXA-23 and IMP carbapenemases is an important mechanism of resistance to carbapenem antibiotics ,and there is prevalence of the same clones in these carbapenem-resistant strains .

Objective To analyze the detection rate and drug resistance tendency of Acinetobacter (A .) baumannii in Meizhou area during 2008-2012 in order to provide the guidance for clinicians′medication .Methods The detection rate and drug resistant rate of A .baumanii in the clinical specimens submitted from 5 hospitals in Meizhou during 2008 -2012 were retrospectively ana-lyzed .The antimicrobial susceptibility test was performed by the disk diffusion method .The WHONET 5 .4 and SPSS18 .0 soft-wares were adopted to analyze the data .Results The detection rates of A .baumanii in these five years were 12 .91% ,15 .40% , 11 .94% ,13 .59% and 14 .00% respectively .In the sources of strains ,sputum had the highest distribution rate of 68 .99% (1 713/2 483) ,in the distribution of departments ,ICU had the highest distribution rate of 33 .91% (842/2 483) .The resistance rate of A . baumannii to cefoperazone/shubatam ,meropenem and imipenem were below 30% in the five years ,but showed the upward tenden-cy .The 5-year total drug resistance rates of A .baumanii to 18 kinds of antibacterial drugs were statistically different between ICU and non-ICU department (P<0 .05) ,the drug resistant rate of isolates from ICU was higher than that from the non-ICU depart-ments .The isolation rate of multi-drug resistant strains of A .baumanii was fluctuated in about 50% during these five years except the lower isolation rate in 2008 ,the isolation rate of pan-drug resistant A .baumanii and carbapenem resistance A .baumanii showed the upward tendency .Conclusion The drug resistance rate of A .baumanii is gradually increased .The drug resistance monitoring of A .baumanii in ICU should be strengthened .Antimicrobial agents should be reasonably used for maximizing to retard the emergence of drug resistant strains .

Objective To investigate the value of intravoxel incoherent motion MR imaging (IVIM-MRI)on monitoring impairment of renal function in hydronephrosis.Methods Left hydronephrosis model of Healthy New-Zealand rabbits made by ureteral incomplete obstruction were scanned by IVIM-MRI at 4, 8, 12, and 16 weeks.The change of IVIM-MRI quantitative parameters (ADC values, D values, D* values, and f values) in left hydronephrosis kidney were observed.The correlation between these parameters and glomerular filtration rate (GFR) were evaluated.Results ADC values, D values, D* values and f values at cortex and medulla in left hydronephrosis model of rabbits decreased gradually in the progression of renal damage after 4, 8, 12, and 16 weeks.For D value, f value and ADC values, there was statistical significant difference among the group of 12 weeks, the group of 16 weeks, the control group, and the group of 4 weeks;statistical significant difference was also observed between the group of 8 weeks and the group of 16 weeks by LSD contrast.ADC values, D values, D* values, and f values were positively correlated to GFR at 4, 8, 12, and 16 weeks for left hydronephrosis model of rabbits.Conclusion IVIM-MRI could monitor impairment of renal function in hydronephrosis dynamically.