0.05),whereas DC number in T-NHL was fewer than that in normal control(P

Objectiye To explore the expression of COX-2 and VEGF and its clinical significance in non-Hodgkin lymphoma (NHL). Methods The expression of COX-2 and VEGF were detected by immunohistochemistry in 42 cases of NHL and 20 cases of lymph node with benign pathological change. Results The positive rate of COX-2 and VEGF was 45.24% and 73.81% in NHL respectively. The expression rate of VEGF was positively correlated with that of COX-2 in tissues of NHL ( x2 = 4. 63, P ＜ 0. 05).The expression of COX-2 was related to clinical stage and histopathologic grade of NHL ( x2 = 5.43, P ＜0. 05), but it had no association with gender, age, B symptoms, and IPI. The expression of VEGF was significantly related with aggression, B symptoms and IPI ( x2 =8. 979, 8. 893,6. 434, P ＜0. 05), but it had no association with age, gender and clinical stages. Conclusion COX-2 and VEGF may be involved in NHL tumorgenesis, and COX-2 may accelerate angiogenesis by increasing VEGF expression. Specific COX-2 inhibitors may be a novel therapeutic approach for NHL.

BACKGROUND:Hemostatic dressing can directly contact with the body tissues on the wound surface. The biocompatibility is one of the important indicators of evaluating the advantages and disadvantages of dressing. The hemostatic dressing prepared with calcium alginate as raw material has become a research focus owing to its low cost and good compatibility. OBJECTIVE:To observe the cytotoxicity of calcium alginate hemostatic dressings and to compare the cytotoxicity between calcium alginate hemostatic dressing and gelatin hemostatic sponge, absorbing cotton, ordinary gauze. METHEDS:Leaching solution method: the DMEM high glucose culture solution was taken as the leaching medium. The calcium alginate hemostatic dressing, gelatin hemostatic sponge, absorbing cotton and ordinary gauze leaching solution were respectively prepared. Five concentration gradients of 100%, 75%, 50%, 25%, 50% were set. The fibroblast cels of L-929 mouse were cultured for 24 hours with the above material leaching solution. The volume fraction of 10% DMEM high glucose culture medium was taken as control group, and DMEM high glucose culture medium containing 5% DMSO was taken as positive control group to observe the cel proliferation and morphological changes. Direct contact method: The fibroblast cels of L-929 mouse were respectively seeded in calcium alginate hemostatic dressing, gelatin hemostatic sponge, absorbing cotton and ordinary gauze and cultured for 24 hours. The changes in cel morphology were observed.
RESULTS AND CONCLUSION: Leaching solution method: The cytotoxicity of alginate fiber hemostatic dressing, gauze, absorbing cotton leaching solution with different concentration gradients was grade 1, which was in line with GB/T16886/ ISO10993 biological evaluation standard of medical apparatus and instruments. The cytotoxicity of 100%, 75% gelatin hemostatic sponge extract solution was grade 3, causing severe inhibition of cel proliferation. Direct contact method: The cytotoxicity of gauze and alginate fiber hemostatic dressing was grade 1, absorbing cotton was grade 2, gelatin hemostatic sponge was grade 3. These results demonstrate that calcium alginate hemostatic dressing has no cytotoxicity.

Objective To investigate the relationship between erythrocyte immune function and selenium (Se)level. Methods Forty-nine Kashin-Beck patients in endemic area aged 13- 16 years were divided into two groups and were orally given either selenized yeast or sodium selenite to provide 200 μg selenium per day for 12 weeks. Erythrocyte selenium level, glutathione peroxidase activity, the rosette formation rates of red blood cells complement receptor type Ⅰ(CR1), the immune function of red blood cells, and circulating immune complexes(CIC) were determined. Results After supplementing with selenium for 12 weeks, erythrocyte selenium level, glutathione peroxidase activity, the rosette formation rates of red blood cells CR1 were significantly increased. But the difference in rosette formation rates of IC and CIC content was not significant between before and after Se supplementation. Conclusion The increase of the immune function of the erythrocyte by selenium-supplement may be one of the effective mechanisms for the prevention of Kashin-Beck disease.

Objective To investigate the efficacy and safety as well as the effects of rituximab on B-lymphocytes and anti-platelet glycoprotein-specific antibodies,in patients with steroid-resistant idiopathic thrombocytopenic purpura(ITP).Methods Twelve steroid-resistant ITP patients,16 to 54 years old,received intravenous rituximab at the dose of 375 mg/m2 once-weekly for 4 weeks.Lab studies included CBC,serum concentrations of IgG,IgM and IgA.CD+3,CD+4,CD+8,CD+19,CD+20 cell numbers were assayed by flow cytometry and anti-platelet glycoprotein-specific antibodies(GP Ⅱ b/Ⅲ a,GP Ⅰ b/Ⅸ)were assayed by monoclonal antibody-specific immobilisation of platelet antigens prior to and following rituximab therapy.Results A complete response(platelet counts ≥100×109/L)was observed in 4 cases,a partial response (platelet counts between 50 and 100×109/L)in 3 cases,a minor response(platelet counts between 30 and 50×109/L)in 2 cases,and non response(platelet counts＜30×109/L)in 3 cases.Responses were sustained 0.5 to 12 months(median 5 months).After 4 weeks of rituximab therapy,anti-platelet glycoprotein-specific antibodies(GP Ⅱ b/Ⅲ a,GP Ⅰ b/Ⅸ)disappeared except one NR patient and CD+19/CD+20 cells were almost depleted in all patients(295.0±86.4)×106/L vs(4.1±2.2)×106/L(P＜0.01).As expected,the T cell counts,and the serum concentrations of IgG,IgM and IgA were not changed after therapy.No severe side effects were observed.Conclusion Rituximab may be an effective and safe treatment for adults with steroid-resistant ITP.

BACKGROUND:In recent years, calcium alginate dressing has been widely used in surgical hemostasis, traumatic hemostasis, postoperative nasal hemostasis and puncture site hemostasis,etc.; however, there are few reports on their hemostatic mechanisms. OBJECTIVE: To preliminarily study the hemostatic mechanism of calcium alginate dressing. METHODS: Human anticoagulant blood was respectively dropped on sodium alginate dressing, nasopore dressing and medical cotton gauze. After 2 minutes, the interaction between materials and blood was observed at the room temperature using scanning electron microscopy. Calcium alginate dressing, nasopore dressing and medical cotton gauze were added in human red blood cel suspensions respectively. After 15 minutes, the interaction between materials and red blood cels was observed using scanning electron microscopy. The red blood cels were suspended by different concentrations (10, 5, 2.5 g/L) of alginate dressing extracts. The erythrocyte sedimentation rate was observed at different time points (30, 60, 120 minutes). Platelets rich plasma was incubated with different concentrations (10, 5, 2.5 g/L) of alginate dressing extract at 37℃, then CD62P positive platelet percentage was measured by flow cytometry after 10 minutes of incubation. RESULTS AND CONCLUSION: Dense fibrin network was formed after calcium alginate dressing contacting with an anticoagulant. A large number of blood cels were recruited. There were only a smal amount of red blood cels and platelets adhesion in the nasopore dressing and medical cotton gauze groups. After the calcium alginate dressing interacting with red blood cels, red blood cel deformability was visible, with a pseudopodia-like change. The red blood cel morphology was unchanged in the nasopore dressing and medical cotton gauze groups. The calcium alginate dressing extract dose-dependently and time-dependently increased the red blood cels aggregation, comparative differences between groups was statisticaly significant(P < 0.01). The calcium alginate dressing extract dose-dependently enhanced the CD62P positive platelet percentage, comparative differences between groups was statisticaly significant (P< 0.01). These results demonstrate that calcium alginate dressing promotes hemostasis and coagulation process by releasing of calcium ions, causing red blood cel aggregation and deformation and activating platelets.

Objective: To test whether the tryptophan metabolism was abnormal in newly diagnosed ITP patients as well as in these patients after treatment with dexamethasone. Methods: Newly diagnosed patients with ITP between Jan 2014 and May 2015 were enrolled, including 14 females and 11 males, with a median age of 57 years and a median PLT count of 16 (0-32) ×10⁹/L. All patients were treated with oral dexamethasone. The expression levels of IDO mRNA and TTS mRNA in peripheral blood mononuclear cells (PBMC) were analyzed by real-time quantitative polymerase chain reaction. ELISA was used to test the concentrations of IDO and TTS in serum. The concentrations of plasma kynurenine and tryptophan were detected by high-pressure liquid chromatography. Samples from healthy individuals were tested as controls. Results: ①After dexamethasone treatment, 17 patients resulted in persistent remission, 2 cases were ineffective, and relapse occurred in 6 cases at a median follow-up of 11 (6-18) months. ②Before and after dexamethasone treatment, the relative expression of indoleamine2,3-dioxygenase (IDO) mRNA and tryptophanyl t-RNA synthetase (TTS) mRNA showed that there were significant decline in persistent remission group (2.54±0.86 vs 19.85±5.36, t=3.188, P=0.003; 0.68±0.19 vs 45.39±15.83, t=2.842, P=0.008) , compared with the normal control group, the difference was not statistically significant (t=2.313, P=0.027; t=1.127, P=0.268) . After treatment, the IDO concentration decreased [ (19.34±0.42) U/ml] and the TTS concentration was markedly increased [ (13.37±0.54) μg/L] in sustained remission group compared with that before treatment [ (21.91±0.37) U/ml] as well as that in normal controls. In particularly, abnormal tryptophan catabolism could be recovered in these 17 patients with persistent remission [Try: (19.85±5.36) μmol/L vs (19.65±4.55) μmol/L, t=1.027, P=0.311; Kyn: (0.56±0.26) μmol/L vs (0.58±0.23) μmol/L, t=2.075, P=0.448]. ③There was no obviously difference in the relative expression of IDO mRNA and TTS mRNA, the concentration of IDO and TTS and the abnormal tryptophan catabolism between before and after treatment of dexamethasone in patients without response and relapsed patients (all P>0.01) . Conclusion The tryptophan catabolism was abnormal in ITP patients, and it could be recovered in patients with persistent remission.

Objective:To construct a perioperative nursing planning for patients with esophageal cancer based on the concept of enhanced recovery after surgery (ERAS) , so as to provide a basis for the development of ERAS nursing for patients with esophageal cancer during perioperative period.Methods:From November 2019 to September 2020, a perioperative ERAS nursing planning for patients with esophageal cancer was constructed through literature retrieval, field observation, Delphi expert consultation, and analytic hierarchy process.Results:A total of two rounds of expert consultations were conducted. The valid recovery rates of the questionnaire were 95.24% (20/21) and 100.00% (20/20) , and the expert authority coefficients were 0.89 and 0.93. The Kendall harmony coefficients were 0.25 and 0.34 ( P<0.01) . The perioperative enhanced recovery nursing planning for patients with esophageal cancer included 5 first-level indicators, 17 second-level indicators and 49 third-level indicators. Conclusions:The perioperative enhanced recovery nursing planning for patients with esophageal cancer is scientific and reliable, and can effectively standardize and guide the development of clinical nursing work.

Objective:To investigate the efficacy and safety of daratumumab (Dara) - combination regimens for newly diagnosed multiple myeloma (NDMM).Methods:A retrospective case series study was conducted. The clinical data of 34 patients with NDMM receiving treatment regimen including Dara from Qilu Hospital of Shandong University, Yantai Yuhuangding Hospital, Huangdao Branch of Affiliated Hospital of Qingdao University and Taian City Central Hospital between April 2020 and March 2022 were retrospectively collected. The efficacy, survival and adverse reactions of patients were analyzed. Cox proportional risk model was used to analyze the factors affecting overall survival (OS) and minimal residual disease (MRD) turning negative.Results:Among 34 patients with NDMM, there were 19 males and 15 females, with 21 cases aged < 65 years and 13 cases aged ≥65 years. The median follow-up duration [ M ( Q1, Q3)] was 22 months (19 months, 26 months), the median of Dara treatment cycles was 7 (5, 11), and the overall response rate (ORR) reached 97.1% (33/34). There were statistically significant differences in the optimal efficacy of patients stratified by receiving hematopoietic stem cell transplantation or not and receiving different treatment cycles (all P ≤ 0.05), while there were no statistically significant differences in patients stratified by other clinical features (all P > 0.05). The 1-year progression-free survival rate was 79.4% and the 1-year OS rate was 94.1%. Multivariate Cox regression analysis showed that the cycle number of treatment regimens containing Dara was an independent influencing factor of MRD turning negative (6 cycles vs. 2 cycles, HR = 0.267, 95% CI: 0.076-0.935, P = 0.039); age ≥ 65 years was an independent risk factor for OS ( HR = 35.313, 95% CI: 1.709-729.669, P = 0.021). The incidence of hematological adverse reactions grade 3 or above was 20.6% (7/34), and the non-hematological adverse reactions primarily included infection [44.1% (15/34)] and edema of extremity and trunk [41.2% (14/34)]. Conclusions:The Dara-based regimens for NDMM exhibit a high ORR. The remission depth accelerated with the increasing number of treatment cycle, and the adverse reactions are mild.

Objective To observe optimized nursing strategy for thoracic closed drainage and its clinical outcomes.Methods A total of 109 patients treated with thoracic closed drainage were retrospectively analyzed, and the patients were divided into two groups according to the order of admission, 58 cases in observation group treated with optimized nursing care, and 51 in the control group treated with regular health care.The incidence of complications, SAS, SDS scores and nursing satisfaction in two groups were compared.Results The incidences of decubitus and atelectasis, and total incidence of complications in the observation group were significantly lower than that in the control group.The Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) score in patients in the observation group given psychological counseling were significantly lower than that in the control group.The total satisfaction in the observation group was significantly higher than that in the control group(P<0.05).Conclusion The optimized nursing for patients with thoracic closed drainage can significantly reduce the risk of adverse reactions, alleviate the anxiety and depression and improve the satisfaction towards hospital nursing.Therefore, it is worthy of application in the future clinical nursing.