Child ; Female ; Humans ; Sarcoma, Myeloid ; Spine ; pathology

Objective To analysis the clinical features of elderly diffuse large B-cell lymphoma (DLBCL) patients with Epstein-Barr virus (EBV) infection and their prognostic factors.Methods 250 cases of DLBCL were retrospectively studied by in situ hybridization (ISH) to detect the EBV and by immunohistochemical to evaluate the histological type and Ki-67 protein.Results 36 cases with EBVpositive included 28 elderly (aged ≥ 60 years), of which 21 cases were Han, 15 cases were Uygur, male/ female ratio was 2 : 1.There were 23 cases with nodal presentation only, 13 cases with extra-nodal presentation.Twenty-nine patients presented with advanced disease (Ann Arbor stage Ⅲ/Ⅳ), 30 patients were found with high lactate dehydrogenase (LDH), 22 patients with high IPI score (3-5).Histological observation showed a diffuse and polymorphic proliferation of large lymphoid cells with varying degrees of reactive components.These tumor cells were frequently characterized by a broad range of B-cell maturation, containingcentroblasts, immunoblasts, and Hodgkin-and Reed-Stemberg (HRS)-like giant cells.Immunohistochemical studies showed that tumor cells were positive for CD20 and (or) CD79a in almost cases, most of the cases had a high proliferative index.CD10, bcl-6, Mum-1 performed histological type, 31 cases were non-germinal center.Except the age and location (P ＜ 0.05), no other significant differences were observed in Han and Uygur elderly EBV+ DLBCL (P ＞ 0.05).Conclusion The incidence of elderly EBV+ DLBCL is low, it has some unique clinical and pathological features with poor prognosis.

Background and purpose:Advanced and metastatic colorectal cancer is the second leading cause of cancer death. In the past ,the standard treatment for patients with advanced CRC was fluorouracil(5-FU) biochemically modulated by leucovorin(LV), which demonstrated a response rate of about 23% .In 1990s, a number of new treatment options have been available. In particular, one new cytotoxic agent ,irinotecan (CPT-11), which is a specific inhibitor of topoisomerase I, have been proven to have efficacy in the tretment of CRC .Furthermore, several first-line phase Ⅲ trials show a significant improvement in result with the addition of CPT-11 to FU-LV combination therapy (FOLFIRI).We observed the survival situation, efficacy and safety of irinotecan plus 5-FU/LV after first-line chemotherapy failure for Chinese patients with advanced or/and metastatic colorectal cancer. Methods:Twenty-four patients with metastatic colorectal cancer whose disease had progressed after treatment with first-line oxaliplatin or other chemotherapeutics were included to receive biweekly FOLFIRI regimen (irinotecan 180mg/m~ 2 on day 1,with LV 200mg/m~ 2 adiministrated as a 2-hour infusion before 5-FU 400mg/m~ 2 administrated as an intravenous bolus injection and FU⒉4g/m~ 2 as 46-hour infusion immediately after 5-FU bolus ).All the patients were planned to receive at least 6 cycles of chemotherapy .They were assessed on the basis of WHO evaluation standard of objective therapeutic effect for solid tumor.Results:24 patients were assessable to observe the efficacy and safety. No case was CR.5 case were PR, response rate was 20% (5/24). 17 case were SD , rate was 70% (17/24). 2 case were PD, rate was 8%(2/24). Median time to progression (TTP) were 6.6 months (6 to 24 months ),median overall survival was 10.7 months. The majority of adverse reaction were nausea, vomiting, anorexia, diarrhea, leucopenia, alopecie. Most of them were Ⅰ/Ⅱ degree, only 6 cases reached III/IV degree. 3 cases had diarrhea with leucopenia and fever.Conclusions:The biweekly regimen of irinotcan in combination with 5-FU/LV results in significant and clinically meaningful improvement in survival and quality of life among patients with metastatic colorectal cancer. Toxicity is manageable.

Objective To investigate the effect of early warning face pattern of weight combined with health education in weight management of maintenance hemodialysis patients.Methods Toally 223 maintenance hemodialysis patients hospitalized in the hospital from July to December 2014 (17,617 cases of hemodialysis) were set as the control group and 223 maintenance hemodialysis patients from January to June 2015 (17,281 cases of hemodialysis) were set as the experiment group.The control group was given routine health education and the experiment group was given health education and early warning face pattern of weight.The two groups were compared in terms of the ratio between interdialytic weight gain (IDWG) and interdialytic dry weight ratio (IWGR) as well as the hemodialysis-related complications.Results The IDWG/IWGR ratio in the experiment group was significantly better than that of the control group (P＜0.05).The incidence of hemodialysis-related complications were significantly lower than that of control group.Conclusion Early warning face pattern of weight used in health education can effectively control the patient's interdialytic weight gain (IDWG) and reduce the hemodialysis-related complications.

OBJECTIVE:To establish the quality standard of Huoxuesan. METHODS:Microscopic identification method was adopted for the qualitative identification of Rhizoma pinelliae,Eupolyphaga seu,Phellodendron amurense and Fructus kochiae in the preparation. HPLC was adopted for the contents determination of phellodendrine,polydatin,jatrorrhizine,berberine and emo-din:the column was ZORBAX Eclipse Plus C18 with methanol-0.1% phosphoric acid(gradient elution)at a flow rate of 0.4 ml/min,the detection wavelength was 240 nm,column temperature was 30 ℃,and the injection volume was 5 μl. RESULTS:Micro-scopic identification map of R. pinelliae,E. seu,P. amurense and F. kochiae was clear. The linear range was 0.159-5.073 μg(r=0.997 4)for phellodendrine、0.149-4.761 μg(r=0.999 9)for polydatin、0.239-7.649 μg(r=0.995 5)for jatrorrhizine、0.165-5.268 μg (r=0.997 2)for berberine、0.012-0.382 μg(r=0.999 9)for emodin;RSDs of precision,stability and reproducibility tests were low-er than 3.0%;recoveries were 98.9%-104.1%(RSD=1.9%,n=6),96.1%-101.7%(RSD=2.5%,n=6),99.6%-105.1%(RSD=2.6%,n=6),90.3%-98.2%(RSD=2.9%,n=6)and 92.9%-96.4%(RSD=2.0%,n=6)respectively. CONCLUSIONS:The es-tablished standard can be used for the quality control of Huoxuesan.

The visual acuity testa were performed in 8219 children(16 438 eyes)under 5 years of age with sound and light toys,electric torch and a retinoscope.The general ocular examination and mydriatic optometry were also performed for the ametropia.In 8219 children 61 were found to have dominant strabismus,including 59 cases of concomitant strabismus and 2 paralytic strabismus.AbnormaJ refraction was detected in 404 children(739 eye)accounting for 4.92%,including 68 cases of anisometropia (0.83%).In 16 438 eyes 621(3.78%)were moderate or hyper-presbyopia;53(0.32%)were myopia;65 (0.40%)were mixed astigmatism.The vision acuity test described above is a simple and convenient method suitable for children under 5 who are not able to read the conventional test chart.

Objective This study is aimed to assess the accuracy of clinical measurement of remission and investigate the association between clinical remission and the ultrasound imaging assessment of synovitis and infla'mation and to explore the value of ultrasound imaging in the evaluation of disease activity in the tight control of rheumatoid arthritis (RA).Methods RA patients with a disease activity score in 28 joints (DAS28-ESR) ≤2.6 for at least 3 months were stratified-using a standard and more stringent DAS28 and simplified disease activity index (SDAI) remission thresholds and the corresponding clinical and ultrasound imaging measures of synovitis were recorded.In addition,a retrospective analysis of disease activity in patients was carried out.Mann-Whitney U test,x2 test and multi-factor analysis of variance of repeated measurements were used for statistical analysis.Results A total of 48 cases were recruited.Thirty-seven cases (77％) met the ACR remission criteria,29 cases (60％) fulfilled the SDAI remission criteria,and 32 (67％) cases reached 2010 ACR/EULAR Boolean-based definition of remission criteria.There was no significant differences on imaging disease activity between SDAI remission patients and those who were not in remission (GS score,P=0.38; PD score,P=0.32).Seventy-nine percent patients in SDAI remission had GS and/or PD activity,but the difference was not statistically different when compared with patients who did not reach SDAI remission (P=0.29).Sustainable remission obtained in patients who also had achieved image remission could have longer remission time (P＜0.01) Conclusion Using more stringent clinical remission criteria could help in reducing residual inflammatory activity of,but ultrasound PD activities may not be significantly reduced.Integrated clinical indicators such as physical examination and imaging tools such as ultrasound can provide more accurate assessment of disease activity and could be used to guide treatment to achieve trueremission.

Objective To investigate the expressions of serum cystatin C CysC),retinolbinding protein (RBP),serum and urinary β2-microglobulin (β2-MG) and their effects on predicting renal damage in primary hypertension in elderly patients.Methods A total of 149 patients were divided into 3 groups of hypertension grade 1 (n =50),hypertension grade 2 (n =50) and hypertension grade 3 group (n=49).92 healthy controls who took physical examination were selected as control group.The levels of serum CysC,RBP,serum and uric β2-MG,blood urea nitrogen,creatinine and other biochemical indexes were detected.The complications of hypertension were observed.The differences in renal function indexes between groups and their correlations were analyzed.Results There were 86 cases with hyperlipidemia (57.7％),71 cases with atherosclerosis (47.7％),59 cases with type 2 diabetes mellitus (39.6％),56 cases with coronary heart disease (37.6％),and 49 cases with cerebral vascular disease (32.9％) in 149 hypertensive patients.The levels of serum CysC,RBP,serum and uric β2-microglobulin were increased in hypertensive patients as compared with healthy controls (P＜0.05 or 0.01),and the extents of increments in the above indexes were positively correlated with blood pressure level [CysC:(1.2± 0.5) mg/L,(1.7±0.6) mg/L,(2.2±0.9) mg/L;RBP:(53.1±10.2) mg/L,(65.2±16.3)mg/L,(75.8±17.5) mg/L;serum β2-MG:(2.7±1.5) mg/L,(4.0±2.1) mg/L,(4.9±2.0) mg/L;uric β2-MG:(178.3±73.9) ng/L,(237.9±78.6) ng/L,(277.5±87.5) ng/L;respectively,P＜0.05or 0.01].Conclusions Elderly hypertensive patients are complicated with a variety of diseases.The levels of serum CysC,retinol-binding protein,serum and uric β2 microglobulin have significant diagnostic values on renal impairment caused by hypertension,and can be considered as sensitive factors for early renal impairment in essential hypertension.

Objective To optimize the particle size of Huoxue powder by contents comparison of emodin,phellodendrine,berberine and jatrorrhizine before and after permeabilized skin absorption of Huoxue powder in different particle size of 0.150,0.075,0.048,0.038 mm.Methods The contents of emodin,phellodendrine,berberine and jatrorrhizine in transparent absorbent fluid of Huoxue power in different particle size within 24 hours were measured by ultra performance liquid chromatography tandem mass spectrometry,and optimize its particle size by contents comparison of the effective components.Results The contents of the active components in Huoxue power with the particle size of 0.075 mm were high before and after percutaneous absorption.Conclusion Particle size of 0.075 mm is best for Huoxue powder.

Objective To investigate the clinical efficacy of the laparoscopic Roux-en-Y gastric bypass (LRYGB) and metformin in the treatment of obese patients with type 2 diabetes mellitus,and influencing factors of remission rate of diabetes.Methods The case-control study was conducted.The clinical data of 172 obese patients with type 2 diabetes mellitus who were admitted to the First People's Hospital of Shangqiu (43 patients) and the First Affiliated Hospital of Sun Yat-sen University (129 patients) from June 2010 to June 2015 were collected.Of 172 patients,82 undergoing LRYGB were allocated into the group A and 90 taking oral metformin were allocated into the group B.Observation indicators:(1) follow-up situations;(2) comparison of metabolic indices after treatment between the 2 groups;(3) influencing factors analysis of remission rate of diabetes in patients undergoing LRYGB;(4) influencing factors analysis of remission rate of diabetes in patients taking oral metformin.Follow-up using outpatient examination and telephone interview was performed to detect occurrence of treatment-related complications up to January 2017,and metabolic indices were measured regularly.Measurement data with normal distribution were represented as ±s and comparison between groups was analyzed using the independent-sample t test.Repeated measurement data were analyzed by the repeated measures ANOVA.Comparisons of count data were evaluated by the chi-square test.The univariate analysis and multivariate analysis were respectively done using the chi-square test and Logistic regression model.Results (1) Follow-up situations:172 patients were followed up after treatment for 19-43 months,with a median time of 28 months.During the follow-up,5 patients complicated with mild diarrhea and 1 complicated with iron deficiency anemia at 1 year postoperatively were improved by symptomatic treatment in the group A,and there was no treatment-related complications in the group B.(2) Comparison of metabolic indices after treatment between 2 groups:body mass,BMI,2-hour postprandial blood glucose (2HPBG),2-hour postprandial serum C-peptide,glycosylated hemoglobin (GHb),fasting insulin,2-hour postprandial insulin (2HPI),low-density lipoprotein (LDL) and cases with hypertension in the group A were (89±6) kg,(31.5±2.0) kg/m2,(19.4±3.9) mmol/L,(3.52± 0.32) μg/L,15.7％ ±5.3％,(8.0± 1.4) uIU/L,(20.6± 2.5) uIU/L,(3.7 ± 1.3) mmol/L,24 before LRYGB and(77±16)kg,(24.2±2.9)kg/m2,(10.6±2.6) mmol/L,(7.19± 2.23) μg/L,5.3％±4.5％,(9.2± 4.3)uIU/L,(28.3±2.9)uIU/L,(2.2±2.1)mmol/L,9 after LRYGB,respectively,with statistically significant differences between preoperative and postoperative indicators (F=2.112,3.026,1.253,2.107,1.257,3.473,1.223,2.584,x2 =8.540,P ＜ 0.05).Fasting blood glucose,2HPBG,fasting serum C-peptide,2-hour postprandial serum C-peptide,GHb,fasting insulin and 2HPI in the group B were (11.3±2.5)mmol/L,(18.5± 4.4) mmol/L,(1.54±0.33) μg/L,(3.57±0.91) μg/L,17.5％ ±8.0％,(8.2± 1.3) uIU/L,(21.2±2.6) uIU/L before taking oral metformin and (6.6 ± 1.1) mmol/L,(10.2 ± 2.8) mmol/L,(3.52 ± 1.34) μg/L,(7.68 ± 1.94) μg/L,5.4％ ±2.1％,(9.6± 3.9) uIU/L,(30.3± 3.1) uIU/L after taking oral metformin,respectively,with statistically significant differences between before and after taking oral metformin (F=1.245,3.224,3.127,2.064,3.672,2.074,1.137,P＜0.05).Remission rate of diabetes and excess weight loss (EWL) in patients after treatment were 14.6％,80％ ± 15％ in the group A and 11.1％,60％ ± 10％ in the group B,respectively.There were statistically significant differences in body mass,BMI and EWL after treatment between the 2 groups (t=1.973,2.326,2.347,P＜0.05),and no statistically significant difference in remission rate of diabetes between the 2 groups (x2 =0.477,P＞0.05).(3) Influencing factors analysis of remission rate of diabetes in patients undergoing LRYGB:the results of univariate analysis showed that BMI,diabetes duration and LDL were factors affecting remission rate of diabetes in patients undergoing LRYGB,with statistically significant differences (x2=11.267,9.519,5.567,P＜0.05).The results of multivariate analysis showed that diabetes duration ＜ 10 years was an independent factor affecting good remission rate of diabetes in patients undergoing LRYGB,with statistically significant differences [OR=2.202,95％ confidence interval (CI):1.418-3.420,P＜0.05].(4) Influencing factors analysis of remission rate of diabetes in patients taking oral metformin:the results of univariate analysis showed that diabetes duration,GHb and LDL were factors affecting remission rate of diabetes in patients taking oral metformin,with statistically significant differences (x2 =6.306,7.758,4.652,P＜0.05).The results of multivariate analysis showed that GHb ＜ 15.0％ was an independent factor affecting good remission rate of diabetes in patients taking oral metformin,with statistically significant differences (OR=3.167,95％CI:1.586-6.325,P＜0.05).Conclusions LRYGB and oral metformin in the treatment of obese patients with type 2 diabetes mellitus are safe and effective,showing an equivalent remission rate of diabetes,and LRYGB had an advantage of weight loss.Diabetes duration ＜ 10 years and GHb ＜ 15.0％ are respectively independent factors affecting good remission rate of diabetes in patients undergoing LRYGB and taking oral metformin.