As recent researches suggested,the continuous infusion and novel targeted medicines have been expected to improve the outcome of patients with aggressive B-cell non-Hodgkin's lymphoma.Nevertheless,it does not improve the curative effect by increasingly intensive dosage.Patients with aggressive T-cell non-Hodgkin's lymphoma have present better prognosis recently,which is attributed to better efficacy of the modified regimens in patients with NK/T cell lymphoma.Multiple genetic abnormalities are implicated in poorer prognosis in patients with aggressive T-cell non-Hodgkin's lymphoma.Non-myeloablative allogeneic stem cell transplantation and new targeted drugs have improved the curative effects.Radiotherapy with modern technology also is expected to become an important means to improve outcomes of aggressive non-Hodgkin's lymphoma.

Objective To explore coronary angiography detection in coronary heart disease patients with left ventricular ejection fraction decreasing. Methods The clinical data of 120 coronary heart disease patients were retrospectively analyzed. And the patients were divided into observation group and control group by decreasing of left ventricular ejection fraction. Results The incidence rate of more affection, anterior descending branch, convolution branch,left bole affection were higher than control group;The Gensini points of detection group were higher than control group( P ＜ 0. 05) ,and the difference was statistical significance. Conclusion Close attention on the changes of left ventricular ejection fraction in the clinic could provide reliable theory base.

Streptomycetes are Gram-positive bacteria of Actinomycetales. These organisms can produce many economically important secondary metabolites. With the development of molecular biology, gene sequencing technology and synthetic biology, people gained a better understanding of the Streptomyces family. The means to transform genome on the molecular level is also increasing. By simplifying the Streptomyces genome rationally and efficiently, it will improve the yield and quality of the metabolites as well as reduce the consumption of the substrates. Markerless knockout is an important way to carry out genetic modification. Here we describe novel genome modification techniques developed for Streptomyces in recent years with focus on the markerless knockout technologies.
Chromosomes, Bacterial ; genetics ; Gene Knockout Techniques ; methods ; Genes, Bacterial ; genetics ; Streptomyces ; genetics

While Choledocholithiasis is concomitant with gallstones in approximately 9.2％ ～ 14.3％ of the patients,and its treatment methods are mainly by surgery,including:(1)Open cholecystectomy and open choledocholithotomy 、T-tube drainage (OC-OCHTD) ; (2) Endoscopic retrograde cholangiopancreatography (ERCP) and Endoscopic sphincterotomy (EST),and followed by Laparoscopic cholecystectomy (LC) second stage (ERCP/EST + LC) ; (3) Laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration (LC +CBDE).These three methods all have their own characteristics.The last two methods are minimally invasive surgery treatment.Practice has proved that LCBDE and ERCP + EST + LC treatment methods are feasible and show certain advantages,compared with OC-OCHTD reflecting the development of minimally invasive surgery.Practice has proved that LCBDE and ERCP + EST + LC treatment methods are feasible and show certain advantages,compared with OCHTD reflecting the development of minimally invasive surgery.But the indications of operation are need to be summarized constantly in clinical practice,while operation skills are also need to be improved.At present,many reports of the two methods of minimally invasive treatment have been published because of the controversy,such as surgical indications,hospitalization expense,operation time,therapy danger,complications and the length of hospital stay.Both LCBDE and ERCP + EST + LC show some advantages and disadvantages compared with each other.On proper indications,LCBDE embodies the superiority of minimally invasive surgery technology as a one-stage operation,which is preferred for patients of choledocholithiasis with concomitant gallstones.For patients,no matter what kind of operation method,less invasion,lower risk and less complications is the key for best treatment choise.

Objective To evaluate the applicability of small molecular markers of nephrotoxicity that in prediction of drug toxicity.Method Extracts of five kinds of traditional Chinese medicines (Tripterygium wilfordii,Strychni semen,Aristolochiafangchi,Rhei Radix et Rhizoma,and Xanthium sibiricum) that had known as nephrotoxicity were ig given to rats to establish renal injury models,and the blood samples were collected after administration for 1 and 7 d.Then blood samples were analyzed by UPLC/Q-TOF-MS for five kinds of small molecule biomarkers-thymidine,lyso-phosphatidylcholine (LPC 16:1),LPC (18:4),LPC (20:5),and LPC (22:5).The support vector machine (SVM) prediction model was established to determine the toxicity.The levels of Cr and BUN in serum were determined by automatic biochemical analyzer.The rats in each group were sacrificed after blood collection,and the kidneys were taken for HE staining.Result No toxicity was observed in the control group,and the biochemical test results showed no renal injury after mentioned five kinds Chinese herbs were given for 1 d,while SVM model of nephrotoxicity had been found abnormal.After administration for 7 d,the results of SVM model show renal toxicity,which were consistent with biochemical and pathological examination.Conclusion Metabonomics combined with the earlier established SVM model enabled prediction of drug nephrotoxicity more sensitively,quickly and \ccurately,and it is of great significance for the discovery of drug toxicity as well as the prevention and treatment of drug-induced renal injuries in clinic.

Objective To evaluate the effect of atorvastatin on patients with hepatolithiasis and obstructive jaundice after partial hepatectomy.Methods We retrospectively analyzed the data of 51 patients with hepatolithiasis and obstructive jaundice who were treated with partial hepatectomy from July 2006 to August 2015 at Xishan People's Hospital of Wuxi.Based on whether atorvastatin was used or not,the patients were divided into the treatment group (25 patients) and the control group (26 patients).Liver function tests were determined regularly after operation.The serum liver function on postoperative day 3 (P3d) and postoperative day 5 (P5d),complications (incisional infection,abdominal infection,pleural effusion,peritoneal effusion and bile leakage) and duration of hospital stay in the two groups of patients were compared.Results There was no perioperative death in the two groups.When compared with the control group,liver function data suggested an improvement in the treatment group,as ALT and AST in the treatment group were significantly lower than in the control group on P3d and P5d [ALT (252.6 ± 87.0) U/L vs (385.0 ± 152.9)U/L,(89.9 ±28.2) U/L vs (116.9 ±29.3) U/L;AST(130.7 ±66.9) U/L vs (212.7 ±80.0) U/L,(47.5 ± 16.1) vs (69.2 ± 12.2) U/L,all P ＜ 0.05].When compared with the control group,the serum cholesterol level was lower on P3d and P5d [TC:(6.7 ± 0.3) mmol/L vs (6.2 ± 0.3) mmol/L;(6.1 ± 0.4) mmol/L vs (7.0 ± 0.4) mmol/L,P ＜ 0.05],the serum CRP level was also lower in the treatment group [(56.8 ± 15.7) mg/L vs (98.9 ± 40.3) rg/L,P ＜ 0.05];the duration of hospital stay was (10 ± 1) days in the treatment group,which was significantly different from the control group (12 ± 1) days.Conclusion The use of atorvastatin in patients with hepatolithiasis and obstructive jaundice who were treated with partial hepatectomy improved postoperative liver function and shortened postoperative hospital stay.

Objective To compare the safety and efficiency of laparoscopic cholecystectomy (LC) + laparoscopic common bile duct exploration (LCBDE) with endoscopic retrograde cholangiopancreatography (ERCP) /endoscopic sphincterotomy (EST) +LC for patients with concomitant gallstones and common bile duct stones.Methods The Pubmed,EMBASE and CNKI were searched for randomized controlled trials published from 1990 to March,2012.Revman 5.1 was used to perform the meta-analysis.The main outcomes were stone clearance rate,treatment morbidity,operative time and length of hospital stay.Results 9 studies with 1021 patients were included into the final analysis.Meta-analysis demonstrated that LC+LCBDE was similar to ERCP/EST+LC in the stone clearance rate (OR 1.55,95％CI 0.95～2.52,P=0.08),treatment morbidity (OR 1.12,95％CI 0.75～1.67,P=0.58),operative time (WMD-54.44,95％CI-107.7～-1.17,P=0.05) and length of hospital stay (WMD-0.22,95％CI-2.6～2.16,P=0.86).The P value of the stone clearance rate was approaching 0.05 with increased number of studies in the analysis.There was no significant difference in the operative time,probably because of small sample size.Conclusions LC-LCBDE was equivalent to ERCP/EST+ LC in stone clearance rate,treatment morbidity,operative time and length of hospital stay.There is a possibility that LC+LCBDE can be superior to ERCP/EST+LC in the stone clearance rate and the operative time with increase in sample size.

Objective To investigate the clinical efficacy and summarize the experience of treating patients with hepatic injuries in a primary-care hospital.Methods The clinical data of 230 patients with hepatic injuries from January 2002 to December 2014 were retrospectively analyzed.Results 124 patients were treated with surgery and 106 patients (including two patients who were transferred to another hospital) were managed by conservative treatment.Of 230 patients,204 patients recovered well and 26 patients died.63 cases of severe hepatic injuries (grades Ⅲ,Ⅳ,Ⅴ and Ⅵ),the mortality rate reached 25.4％.Concltsions The important points to success in managing these patients are early diagnosis and adequate assessment of liver injury,proper choice of treatment and using the simplest and the most effective means in surgery to control bleeding.

Objective To investigate the relationship between p53,COX-2,Bax,c-myc genes and colorectal carcinoma complicated with chronic schistosomiasis. Methods One hundred and sixty patients with colorectal carcinoma were selected and divided into two groups;a schistosomiasis group(colorectal carcinoma complicated with chronic schistosomiasis,n=80)and a non-schistosomiasis group(colorectal carcinoma uncomplicated with chronic schistosomiasis,n=80). The tissue microarray tech-niques and immunohistochemistry method were used in all the patients to detect the expressions of p53,COX-2,Bax and c-myc proteins. Results The positive rate and level of p53 protein expression in the schistosomiasis group were lower than those in the non-schistosomiasis group,but there were no significant differences between the two groups(both P>0.05). The COX-2 protein in both groups was positive,but the positive expression level of COX-2 in the schistosomiasis group was higher than that in the non-schistosomiasis group,and there was a significant difference between the two groups(P<0.01). The positive rate and level of Bax protein expression were not significantly different between the two groups(both P>0.05). The positive rate of c-myc expression in the schistosomiasis group was higher than that in the non-schistosomiasis group,with a significant difference(P<0.01),but the positive expression level was lower than that in the non-schistosomiasis group,and there was a significant difference between the two groups(P<0.01). Conclusions Schistosome infection may impact on the deficiency of p53 of human colorectal cancer cells. It may promote the excessive expression of COX-2 protein,which is an indirect carcinogenic factor. The expression of Bax gene has no correlation with schistosome infection. The schistosome chronic infection may cause a persistent low level expression of c-myc gene.

Objective To clarify the association of pre-existing choledocholithiasis or cholecystolithiasis and the development of intrahepatic cholangiocarcinoma(ICC).Methods A computerized literature search was performed in Pubmed,EmBase and CBM.Cohort and case control studies on the risk of choledocholithiasis or cholecystolithiasis developing ICC was included.Meta-analysis was performed using STATA version 12.0.Either a fix or random effect model was used according to heterogeneity among studies.Egger's test was performed to assess publication bias.Results A total of 6 case control studies fulfilled our inclusion criteria including 123,713 patients,4,753 for ICC and 118,960 for tumor free controls.Bile duct stone contributed to the development of ICC (OR:15.64,95％ CI 9.33-26.23).Apart from hepatolithiasis,there was still a high risk of ICC development for choledocholithiasis (OR:11.05,95 ％ CI:4.02 ～ 30.37).Cholecystolithiasis is also a risk factor for ICC (OR:2.35,95 ％ CI:1.28 ～ 4.31).Conclusion Both choledocholithiasis and cholecystolithiasis are important prognostic factors for ICC.