ObjectiveTo explore the influence of peritoneal transport characteristics on the nutritional status of patients with continuous ambulatory peritoneal dialysis(CAPD).MethodsSeventy-three CAPD patients were involved in this cross-sectional study.According to the results of peritoneal equilibration test(PET),the patients were divided into high transport group with 43 cases and low transport group with 30 cases.Nutritional status was evaluated with the subjective global assessment (SGA) score and the differences were analyzed between two groups in the albumin (ALB),total protein (TP),hemoglobin (Hb),primary disease,age,weight,dialysis time,ultrafiltration,blood urea nitrogen ( BUN ),serum creatinine (SCr) and so on.Results There was no difference between two groups in age,weight,ultrafiltration,systolic blood pressure,diastolic blood pressure,Hb,SGA score,BUN and SCr (P＞0.05).However,the dialysis time,the case number of diabetic nephropathy (DN) as original disease,the case number of non DN as original disease,TP and ALB between high transport group and low transport group had significant differences [(14.35±13.88) months vs.(24.20 ±19.62) months,16 cases vs.12 cases,27 cases vs.18 cases,( 64.98±7.59 ) g/L vs.( 68.73 ± 6.96 ) g/L,( 34.61 ± 5.43) g/L vs.( 38.71±3.82 ) g/L,P ＜ 0.05 ].Conclusions The nutritional status of CAPD patients with different transport characteristics have significant differences.CAPD patients with high transport characteristics are complicated with worse nutritional status,compared with those patients with low transport characteristics.

To study clinicopathological characteristic of the breast mucosa-associated lymphoid tissue-type-lymphoma (MALT-ML). MethodsFour cases of the breast MALT-ML were studied by HE staining and immunohistochemical technique (ABC method). ResultsOf 4 cases breast MALT-ML, 2 were CCL type, 1 CCL type with blastoid transformation, monotoid Bcell type. By immunohistochemistry, all cases were monoclonity of B-cell with follicular colonization and lymphoepithelia lesions.ConclusionsBreast MALT-ML has a special pathological morphology.

Purpose　To study the clinicopathologic and immunohistochemical characteristics of mantle cell lymphomas(MCL). Methods　Six cases of MCL in lymph nodes were collected and immunohistochemical stains for CD45,CD20,CD79,CD45RO,CD30,CD68,CD43,CD5,cyclinD1,bcl-2,c-myc,IgD and IgM performed. Results　According to the histological pattern, MCL could be divided into 4 subtypes, mantle zone type(1 case), nodular type (1 case), diffuse type (2 cases) and blastoid type (2 cases). The tumor cells were pan-B+, IgD+, CD43+, cyclinD1 + (5/6),CD5+(4/6). Conclusions　MCL is a kind of special immunophenotypic B cell lymphoma. The different histiological subtype may have a different prognosis. The differential diagnosis includes the others B cell lymphomas, for instance, marginal zone B cell lymphomas (MZL),follicular lymphomas(FL), and choronic lymphocytic leukemia/small lymphocytic lymphomas (CLL/SLL).

Purpose　To study the pathological characteristics, diagnostic criteria and differential diagnoses of the lymph node marginal zone B-cell lymphoma (LMZL), for the clinical treatment and prognosis. Methods　Histopathology and immunohistochemistry(ABC method) were used in ten cases of LMZL. Results　There were six male and four female. Lymphadenopathy was the main symptom in all of the cases, of which none had hepatosplenomegaly and abnormal lymphocytes in the peripheral blood. Two of them were marginal zone type, four nodular type, two diffuse type and two blastic type morphologically. Five of them were central cell like (CCL) type, six monocytic B-cell (MBC), two of them lymphoplasmacytic and two blastic histopathologically. Immunophenotyping was done in ten cases and supported the diagnosis. Conclusions　LMZL and MALT-type lymphoma have similar appearance, immunophenotype and cell origin. Based on the structural features, LMZL is a special entity.

Objective:To evaluate the relationship between the phthalate ester exposure and the population obesity with Meta-analysis, and to provide a new idea for prevention and control of obesity. Methods:A comprehensive search was performed in English databases (Pubmed, Web of Science, The Cochrane Library, Elsevier Science Direct and OVID) and Chinese databases (Sinomed database, CNKI database, VIP database, Wanfang database).The studies about the relationship between phthalate ester exposure and the population obesity were retriveded.The Chinese and English studies were selected according to the inclusion criteria and exclusion criteria.Meta-analysis was performed using RevMan 5.3 software.Results:Six studies were finally obtained, involving 1259 samples.The Meta-analysis results showed that the monobutyl phthalate (MBP) level in urine of the obesity population was increased 4.1 times compared with the normal population (95%CI:1.43-6.76);while the combined effect values of dibutyl phthalate (DBP), di-2-ethylhexyl phthalate (DEHP) and diethyl phthalate (DEP) level in serum of the population in two groups were 1.17 (95%CI:0.64-1.69), 0.80 (95%CI:0.13-1.48), and 0.72 (95%CI:-0.19-1.63);the combined effect values of monoethylhexyl phthalate (MEHP) and monoethyl phthalate (MEP) levels in urine were 1.75 (95%CI:-0.45-3.96) and 2.75 (95%CI: 0.36-5.15);there were no significant differences (P>0.05).Conclusion:The elevated MBP levels in the urine may be a risk factor for obesity in the population, suggesting that MBP may contribute to obesity.

We present a case of 32-year-old male with profound mental retardation and autism spectrum disorder who had presented with seizures, rigidity and elevated creatine kinase and was initially diagnosed as neuroleptic malignant syndrome (NMS). The patient subsequently had a complicated clinical course, developing refractory status epilepticus, which lead to the eventual diagnosis of progressive encephalomyelitis with rigidity and myoclonus (PERM). We discuss the clinical similarities and differences between NMS and PERM, and highlight the need to consider alternative diagnoses when the clinical picture of NMS is atypical, particularly in this patient group where the history and clinical examination may be challenging.
Adult ; Autism Spectrum Disorder ; Autistic Disorder ; Creatine Kinase ; Diagnosis ; Encephalomyelitis* ; Humans ; Intellectual Disability ; Male ; Myoclonus* ; Neuroleptic Malignant Syndrome* ; Seizures ; Status Epilepticus

Objective To investigate the incidence of trisomy 12(+12) and 11 q23 deletion [ del ( 11q23) ] in chronic lymphocyticleukemia (CLL). Methods Fluorescein labeled DNA probe 12 and sequence specific probe ATM for 11q23 were used to perform inter-phase fluorescence in situ hybridization (I-FISH) assays in 30 patients with CLL. The results were compared with that of conventional cyto-genetic (CC) examination. Results With CC examination , only 4 cases (13.3%) were found to have chromosomal abnormalities, whereaswith I-FISH assay ,8 cases (26.7%) were found to have genomic aberrations, including trisomy 12 in 5 cases , deletion of 11q23 in 3 ca-sea. Conclusion I-FISH is a useful method for detection of genomie aberration in CLL, the significance of trisomy 12 and del (11q23) inpredicting the prognosis of B-CLL need to be investigated further.

Objective To evaluate the impact of total parenteral nutrition(TPN)on nutrition status and inflammatory markers in hospitalized fasted patients with inflammatory bowel disease(IBD).Methods A retrospective study was performed and 82 hospitalized fasted IBD patients [male/female=58/24,(39.4±14.5)years] who received TPN entered the study.Among them,38 patients had ulcerative colitis(UC)and 44 patients suffered from Crohn`s disease(CD).Clinical data(gender,age,duration of disease,history of disease,prednisone,immuno-suppressor,and antibiotics)were obtained from medical records.Nutritional parameters,C-creative protein(CRP),and erythrocyte sedimentation rate(ESR)before and after TPN were also obtained.Average caloric supplementation by TPN was(4 437.3±1 199.1)kJ/d and the nitrogen amount was(9.9±1.7)g/d.Median PN length was 15 days(7-54 days).67 IBD patients received a TPN formula with glutamine(≥14 d,25 patients vs.0-14 d,42 patients)and 15 IBD subjects received TPN without glutamine.Malnutrition was diagnosed by body mass index(BMI)and serum albumin level.Results The prevalence of undernutrition was 90.2％(74/82)in the study population.CD patients had a significantly longer history of disease [84(3-288)months vs.24(1-324)months,P<0.001] and a significantly lower BMI [(15.6±1.8)kg/m2 vs.(19.1±3.5)kg/m2,P<0.001] compared with those in UC patients.TPN improved nutritional parameters [serum albumin:(28.7±6.6)g/L before TPN vs.(31.7±5.8)g/L after TPN,P<0.001;pre-albumin:(174.1±85.5)mg/L before TPN vs.(227.2±82.8)mg/L after TPN,P<0.001].Conclusions TPN improves nutritional status in hospitalized fasted IBD patients.However,prospective randomized controlled trials are required to estimate the role of low-to-middle dosage of glutamine in IBD patients.

Objective:To investigate the familial inheritances, clinical features, treatments and outcomes of familial Waldenstrom macroglobulinemia (WM) patients.Methods:The clinical manifestations, laboratory examinations, diagnosis and treatments, and follow-up data of 6 familial WM patients who were admitted to Yancheng No.1 People's Hospital from June 2002 to July 2019 were retrospectively analyzed, and the literature was reviewed.Results:Among 6 WM patients, 4 patients had dizziness and fatigue at the onset, 1 patient had recurrent low-grade fever and abnormal sweating as the first manifestations, 1 patient was hospitalized due to pulmonary infection, and WM was found later. Two brothers of the patients were diagnosed with WM, another 2 brothers of the patients had IgM-type monoclonal gammopathy of undetermined significance (MGUS) during the physical examination. All the 6 patients were middle-aged/elderly men, with a median age of 63 years old (51-70 years old). The median follow-up time were 71.5 months (4-217 months), and by the end of the follow-up (June 2020), 2 cases died of pulmonary infection, and 1 of them developed acute myeloid leukemia; the other 4 cases were in regular chemotherapy. Two IgM-MGUS patients were followed up without symptoms.Conclusions:WM patients have familial aggregation, and their clinical manifestations are highly heterogeneous. Patients with family history may have poor prognosis. It is necessary to strengthen the awareness of WM and family history screening.

Background: Some of the active perianal fistulizing Crohn's disease (CD) patients achieving remission with infliximab (IFX) therapy would develop relapse of perianal fistula within weeks to years after discontinuation of IFX therapy. Aims: To assess the outcomes of patients with perianal fistulizing CD after discontinuation of IFX therapy and the risk factors for relapse of perianal fistula. Methods: The clinical data of patients with perianal fistulizing CD who received IFX therapy at Shanghai Renji Hospital between June 2013 and May 2019 and stopped IFX therapy after achieving complete or partial radiological remission were collected retrospectively and analyzed. Demographic data, clinical and imaging characteristics, as well as data of IFX treatment and relapse of perianal fistula were extracted. Kaplan-Meier analysis was performed to calculate the cumulative probabilities of perianal and luminal relapse, while Cox proportional hazards model was applied to identify the risk factors for relapse. Results: A total of 56 perianal fistulizing CD patients who had been treated with IFX and stopped IFX therapy were included. Of them 26 achieved complete radiological remission and 30 achieved partial radiological remission. The median follow-up time was 20.5 months. Twenty-one patients (37.5%) had relapse of perianal fistula. The cumulative probabilities of perianal relapse were 29.0%, 33.7% and 42.8% at 12, 24 and 60 months after IFX discontinuation, respectively; and the cumulative probabilities of luminal relapse were 21.7%, 31.2% and 56.4% at 12, 24 and 60 months after IFX discontinuation, respectively. Multivariate analysis showed that non-stricturing and non-penetrating type (HR=9.711, 95% CI: 1.210-77.939, P=0.032) and involvement of rectum (HR=3.034, 95% CI: 1.119-8.231, P=0.029) were independent risk factors for relapse of perianal fistula, while the frequency of using of IFX therapy was a protective factor (HR=0.885, 95% CI: 0.792-0.990, P=0.032). Conclusions: There is a high risk of relapse of perianal fistulizing CD after discontinuation of IFX therapy. Non-stricturing and non-penetrating type and rectal involvement are risk factors for relapse of perianal fistula, and increasing the frequencies of using IFX therapy is crucial for the maintenance of remission.