Objective To investigate the clinical efficiency,safety and prognostic factors of secondline chemotherapy regimen with gemcitabine combined with rituximab in the treatment of relapsed or refractory B-cell non-Hodgkin lymphoma.Methods A total of 157 patients with relapsed or refractory B-cell nonHodgkin lymphoma were selected from July 2008 to February 2015 in Xi'an Central Hospital.Among them,87 patients were given GEMOX regimen (gemcitabine + oxaliplatin) combined with rituximab,and 70 patients were given GDP program (gemcitabine + cisplatin + dexamethasone) combined with rituximab.The chemotherapy efficacies of the two groups were evaluated.At the same time,the patients were grouped according to whether rituximab was applied or not,and the total objective response rate (ORR) difference was compared.The relevant prognostic factors affecting overall survival (OS) were found.The adverse reactions of patients after treatment were observed.Results The ORR of the GEMOX regimen combined with rituximab group was 65.5％,and the ORR of the GDP regimen combined with rituximab group was 55.7％,but the difference between the two groups was not statistically significant (x2 =1.58,P =0.210).The ORR was 75.2％ in 105 patients who had not used rituximab,and the ORR was 32.7％ in 52 patients who had previously received rituximab.The difference between the two groups was statistically significant (x2 =29.50,P ＜ 0.001).Univariate analysis showed that middle-high risk or high risk of the lymphoma international prognostic index (IPI) score (x2 =69.21,P ＜0.001),lactate dehydrogenase (LDH) increased (x2 =16.90,P ＜0.001),refractory patients (x2 =14.43,P =0.001),large mass (x2 =4.57,P =0.030),and failure to achieve CR or PR after salvage chemotherapy (x2 =50.85,P ＜ 0.001) were risk factors for OS.Cox multivariate analysis showed that middle-high risk or high risk of IPI (HR =2.138,95％ CI:1.301-3.512,P =0.001),refractory patients (HR =3.157,95％CI:1.001-10.644,P =0.014),failure to achieve CR or PR after salvage chemotherapy (HR=3.017,95％CI:2.218-7.366,P＜0.001),LDH increased (HR =2.236,95％ CI:1.797-2.781,P =0.001),large mass (HR =1.792,95％ CI:1.255-2.558,P ＜ 0.001) were independent risk factors affecting OS.Adverse reactions to chemotherapy were neutropenia,thrombocytopenia,nausea and vomiting,liver damage and cardiotoxicity,with no treatment-related death.Conclusion The second-line chemotherapy regimen containing gemcitabine combined with rituximab has a better curative effect on relapsed or refractory B-cell non-Hodgkin lymphoma,and the safety is good.Middle-high risk or high risk of IPI,refractory patients,failure to achieve CR or PR after salvage chemotherapy,elevated LDH and large mass were independent risk factors for OS.In patients with relapsed or refractory disease after rituximab treatment,re-application of rituximab was not effective.

Objective To master the prevalence of drinking-water-borne endemic fluorosis of children in the disease affected areas of Liaoning Province and to understand the effect of water improvement measures in prevention and control of fluorosis.Methods The data of 18 water improvement projects in drinking-water-borne endemic fluorosis areas of Liaoning Province from 2011 to 2016 were collected by retrospective method,and the data of dental fluorosis in children aged 8 to 12 years old were analyzed.The prevalence and detection rate of dental flaorosis in children aged 8 to 12 years old were analyzed.To compare the incidence of dental fluorosis among children from villages with qualified water fluoride and those from villages with unqualified water fluoride.Results From 2011 to 2016,in the annual survey of 18 water engineering projects in 18 monitored villages,normal operating rate was between 94.44％ (17/18)-100.00％ (18/18),water fluoride qualified rate was between 88.89％ (16/18)-100.00％ (18/18).In the monitored village,4 941 children aged 8 to 12 were examined,and the detection rate of dental fluorosis was 9.8％ (484/4 941).The dental fluorosis index was 0.19.The detection rate (14.0％,10.7％,10.7％,8.7％,6.6％,8.1％) of dental fluorosis was decreasing year by year (x2trend =24.3,P ＜ 0.05).The total detection rate of children's dental fluorosis in monitored villages (8.1％,356/4 422) with normal operation of water improvement projects and qualified water fluoride was lower than that in monitored villages with excessive water fluoride (24.7％,128/519,x2 =145.1,P ＜ 0.05).Conclusion After water improvement measures are implemented in drinking water fluorosis areas of Liaoning Province,the dental fluorosis of children in the affected areas is effectively controlled,but the problem of excessive fluoride in water improvement projects still exists,and the management of water improvement projects should be strengthened in the future.

Objective:To explore the medical reference values, distribution characteristics and influencing factors of serum iodine in adults with different thyroid health conditions, and to evaluate the importance of serum iodine in evaluating individual iodine nutrition.Methods:From February 2017 to November 2018, multi-stage stratified cluster sampling was used to select one community and one agricultural (fishing) village in the coastal Yingkou City and the inland areas of Shenyang City of Liaoning Province as survey sites. Cluster sampling of adults over 18 years old who had lived for five years were conducted with questionnaire survey, clinical physical examination and thyroid ultrasound examination. Fasting venous blood samples and one random urine sample were collected from all subjects for serum iodine, thyroid hormone, antibody and urine iodine detection. The 95% medical reference value of serum iodine was established by using the percentage quantile method, and the reference value, distribution characteristics and influencing factors of serum iodine in adults with different thyroid health status were analyzed. The diagnostic value of iodine nutritional indicators in thyroid diseases was evaluated by the receiver operating characteristic (ROC) curve.Results:A total of 2 931 adults were surveyed, with serum iodine levels of 62.1 (53.6, 72.2) μg/L, ranging from 5.6 to 642.3 μg/L; urine iodine was 167.6 (111.2, 244.2) μg/L, and the overall iodine level was at an appropriate level. A total of 1 089 patients with thyroid diseases were examined, with a detection rate of 37.2% (1 089/2 931); among them, there were 597 cases of thyroid nodules, 56 cases of endemic goiter, 42 cases of hypothyroidism, 161 cases of subclinical hypothyroidism, 27 cases of hyperthyroidism, 18 cases of subclinical hyperthyroidism, and 474 cases of autoimmune thyroid disease (AITD). There was a statistically significant difference in the detection of thyroid diseases among adults with different levels of serum iodine (χ 2 = 13.80, P < 0.05). The reference values of serum iodine in normal adults, hypothyroidism (without thyroid hormone intervention), hyperthyroidism (without anti thyroid hormone drug treatment), AITD, endemic goiter, and thyroid nodules were 37.2 - 103.0, 12.5 - 52.8, 49.9 - 163.1, 34.3 - 129.3, 27.3 - 92.8, and 37.9 - 119.5 μg/L, respectively. The ROC curve analysis results showed that the serum iodine area under curve(AUC) of patients with hyperthyroidism, subclinical hyperthyroidism, endemic goiter, thyroid nodules, and AITD were 0.94, 0.61, 0.55, 0.53, and 0.52, respectively. The results of univariate analysis showed that there were statistically significant differences in adult serum iodine levels among different positions, regions, age, education level, occupation, iodine intake, blood pressure, and body mass index ( P < 0.05). Conclusions:There are significant differences in serum iodine levels among adults with different thyroid health conditions, and evaluation standards and systems should be developed separately. Serum iodine is an important indicator for evaluating individual iodine nutrition.

The suitable experimental animal model is important in research of pathogenesis and therapeutic strategies of diabetic foot ulcer, and the murine model is the most commonly used one at present. It can be divided into two types: the animal model simulating pathological conditions and the model simulating clinical symptoms. This article reviews the current research progress on the mechanisms of diabetic ulcer pathogenesis, and relevant treatment strategies, including the inhibition of matrix metalloproteinases (MMPs) expression, promotion of angiogenesis and anti-inflammatory therapy.
Animals ; Anti-Inflammatory Agents ; therapeutic use ; Diabetic Foot ; etiology ; genetics ; therapy ; Disease Models, Animal ; Humans ; Matrix Metalloproteinase Inhibitors ; therapeutic use ; Matrix Metalloproteinases ; genetics ; metabolism ; Mice ; Neovascularization, Physiologic ; physiology