Objective:To evaluate the prognostic value of the ratio of androgen receptor splice variant 7 (AR-V7) and androgen receptor (AR) in prostate cancer.Methods:One hundred and five prostate cancer patients treated by castration therapy were selected in this study in People′s Hospital of Gaozhou City, Guangdong Province from March 2013 to March 2018. The expression of AR and AR-V7 in biopsy specimens was detected by immunohistochemistry. The relationship between AR, AR-V7, AR-V7/AR and prognosis of patients was analyzed. Cox regression was used to analyze the related factors affecting prognosis of prostate cancer.Results:The positive rate of AR expression was 59.0% (62/105), and the positive rate of AR-V7 expression was 19.0% (20/105). The patients were followed up for 15 to 61 (44.8 ± 10.1) months. The progression free survival (PFS) and overall survival (OS) in AR-V7 positive patients were significantly shorter than those in AR-V7 negative patients: (10.8 ± 2.2) months vs. (25.0 ± 3.4) months and (20.3 ± 5.1) months vs. (42.8 ± 7.4) months, and there were statistical differences ( P<0.01). The PFS and OS in high AR-V7/AR expression patients were significantly shorter than those in low AR-V7/AR expression patients: (12.5 ± 3.2) months vs. (24.9 ± 5.5) months and (22.5 ± 4.6) months vs. (42.1 ± 8.3) months, and there were statistical differences ( P<0.01). In multivariate Cox regression analyses, T4 stage (HR = 2.618, 95% CI 1.362 to 4.986, P<0.01) and high AR-V7/AR ( HR = 5.799, 95% CI 2.541 to 13.253, P<0.01) could effectively and independently predict the prognosis of hormonal therapy. Conclusions:AR-V7 positive and high AR-V7/AR prostate cancer patients treated by castration therapy may have shorter PFS and OS, compared with AR-V7 negative and low AR-V7/AR patients. High AR-V7/AR is the independent predictor of the prognosis of prostate cancer.

Objective To evaluate the feasibility of using comprehensive geriatric assessment (CGA) in estimating if standard dose treatment is fit for the elderly patients with diffuse large B cell lymphoma.Methods.Comprehensive geriatric assessments including three assessments of activity of daily living,instrumental activity of daily living and comorbidity scoring according to Cumulative Illness Rating Score for Geriatrics were adopted to assess if standard dose treatment is fit for the elderly patients in our prospective study.Thirty seven patients with diffuse large B cell lymphoma,aged ＞70 years were enrolled in the study,and grouped into fit,unfit and frail groups according to comprehensive geriatric assessment scoring and their age.The treatment protocolswere not determined by comprehensive geriatric assessment scores,but by clinical judgments made by clinicians based on their clinical experience and disease features.The clinically effective response and overall survival (OS) were analyzed in the three groups.Results According to CGA scores,patients were grouped into fit [21 cases (56.8％)],unfit [7 (18.9％)] and frail [9 (24.3％)].37 cases received 213 courses of treatment at average 5.76 courses per case.The overall response (complete / partial remission) rates were [85.7％(18/21) vs.28.6％ (2/7) vs.44.4％ (4/9),x2=9.69,P=0.008] and median survival times were (44 months vs.10 months vs.9 months;x2 =7.03,P=0.03) among fit,unfit and frail groups with statistically significant differences.Total effective rate (achieving all clinical targets) in fit group of 21 cases were 100 ％ (12/12)with receiving standard dose therapy,and 66.7％ of(6/9)with low dose therapy(P=0.06).Overall response rate(total/partial remission) [85.7％(18/21) vs.28.6％(2/7) vs.44.4％(4/9),x2=9.69,P=0.008] and median survival (44 months vs.10 months vs.9 months;x2 =7.03,P=0.03) amongfit,unfit and frail groups.In fit group,the two-year overall survival was higher in patients receiving standard dose treatment than receivingpalliativetreatment,with statistical significance [83.3 ％ (10/12) vs.33.3 ％ (3/9),P =0.032],without significant hematologic toxicity observed between the subgroups.Conclusions Comprehensive geriatric assessment can identify if elderly patients diffuse large B cell lymphoma can acquire a satisfactory curative effect from a standard dose treatment ofimmunochemotherapy.

Objective:To evaluate the safety and efficacy of dosing transdermal fentanyl patch by patient-controlled intravenous anal-gesia (PCIA) with fentanyl to treat opioid-naive patients suffering from cancer-related pain. Methods:In this open non-controlled trial, 30 patients with moderate to severe cancer pain were enrolled in the study. Titration conditions, pain score (NRS), and pain of life im-pact scores were assessed and recorded during four periods of treatment, as follows:before fentanyl-PCIA;during fentanyl-PCIA treat-ment;during Duragesic with fentanyl-PCIA treatment;and during Duragesic treatment. Adverse reactions were assessed and recorded during the two periods of treatment (the period before fentanyl-PCIA and the period after fentanyl-PCIA). Results:A total of 20 cases of titration were a success, whereas 10 cases failed. The general pain score, the most serious pain score, activity pain score, resting pain score, and the pain of life impact scores were all significantly reduced during fentanyl-PCIA treatment, during Duragesic with fen-tanyl-PCIA treatment, and during Duragesic treatment compared with the period before fentanyl-PCIA treatment (P<0.05). Nausea was the only adverse reaction that occurred during treatment. Obvious muscle rigidity, loss of consciousness, cough, respiratory depres-sion, and bradycardia were not observed. Conclusion:Dose titration of transdermal fentanyl patch with fentanyl administrated by PCIA for opioid-naive patients provides an effective and convenient method for pain relief treatment.

Objectives To evaluate the efficacy of rituximab combined with chemotherapy in the treatment of diffuse large B-cell lymphoma (DLBCL) and the relationship of clinical prognosis with the International Prognostic Index (IPI) by the using rituximab in autologous peripheral stem cell transplantation (APBSCT) for the patients of DLBCL. Methods 21 patients with DLBCL, 11 patients of them were at IPI low risk, and 3 patients were IPI at low intermediate risk, 3 patients were at IPI high intermediate risk, 4patients IPI high risk. Rituximab combined with CHOP regimen (cyclophosphamide, adriamycin, vincfistine and prednisone) was given for 4～8 courses. 5 patients received APBSCT. The mobilizing regimen was rituximab combined with cyclophosphamide(CTX) and etoposide(VP16). The conditioning regimen were CBV(CTX combined with VP16 and carmustine). Results In 21 patients, the complete response rate was 61.9 %,with overall response rate 90.5 %. 2-year progression free survival was (69.74±10.43)%. 2-year overall survival was (84.44:1:8.35) %. The complete response rate was 92.9 % and overall response rate was 100 % in the patients IPI≤2. The overall response rate was 71.4 % in the patients with IPI≥3. The complete response rate was higher in the patients with IPI≤ 2 (P＜0.01). The amount of mononuclear cells (M NC) in harvest were 7.34 (4.6～8.53)×108/kg. The CD+34 cells in harvest were 8.82 (2.1～10.34)×1O6/kg. The mean time of neutrephil recovering to 0.5×109/L after APBSCT was +9 day. The mean time of platelet recovering to 20×109/L after APBSCT was +12 day. The major adverse reaction were infusion related response (14.3 %) and hematological toxieities. Conclusion The efficacy of rituximab combined with chemotherapy in the treatment of DLBCL is effective, The complete response rate was higher in the patients with IPI≤2 than in the patients with IPI≥3.Using rituximab in mobilizing regimen, all patients had harvested enough CD+34 cells. Rituximab given at +1day did not affect the hematopoiesis reconstruction.

Objective:To investigate the values of ultrasound elasticity(UE)imaging and color Doppler flow energy(CDFI)in differential diagnosis for triple negative breast cancer(TNBC)and fibroadenoma.Methods:A total of 50 TNBC patients who admitted to People's Hospital of Wanning from January 2021 to January 2022 and were confirmed by surgical pathology were selected,and they were divided into TNBC group.On the other hand,a total of 50 patients with fibroadenoma who were confirmed by surgical pathology during the same period were selected and they were divided into fibroadenoma group.All patients did not undergo any clinical intervention before ultrasound examination.UE and CDFI were used respectively to evaluate the degrees of softness and hardness of the tissues,the color blood flow and elasticity scores of lesions.The pathological result was used as the gold standard to analyze respectively the diagnostic efficacies of UE and CDFI for TNBC and fibroadenoma.Results:According to the characteristics of ultrasound imaging,the TNBC group mostly showed burr sign on lesion edge,the attenuation and hyperechoic halo of posterior echo,and existing axillary lymph node metastasis.The fibroadenoma group mostly showed clear boundaries of lesion area,regular lesion morphology,non-microcalcification.The diagnostic sensitivity,specificity and accuracy of UE detection were respectively 90.91%,82.14%and 86.00%,while these indicators of CDFI were respectively 73.08%,75.00%and 74.00%.In addition,the sensitivity,specificity and accuracy of the combined detection of them were respectively 94.23%,95.83%and 96.00%.The detection efficiency of the combined detection was higher than that of each single detection.Conclusion:UE has higher sensitivity in the differential diagnosis of TNBC and fibroadenoma,but it's specificity is not high.The combined detection of UE and CDFI can improve the specificity and accuracy of differential diagnosis.

Influenza virus is the causative agent of the seasonal and occasional pandemic flu. The current H1N1 influenza pandemic, announced by the WHO in June 2009, is highly contagious and responsible for global economic losses and fatalities. Although the H1N1 gene segments have three origins in terms of host species, the virus has been named swine-origin influenza virus (S-OIV) due to a predominant swine origin. 2009 S-OIV has been shown to highly resemble the 1918 pandemic virus in many aspects. Hemagglutinin is responsible for the host range and receptor binding of the virus and is therefore a primary indicator for the potential of infection. Primary sequence analysis of the 2009 S-OIV hemagglutinin (HA) reveals its closest relationship to that of the 1918 pandemic influenza virus, however, analysis at the structural level is necessary to critically assess the functional significance. In this report, we report the crystal structure of soluble hemagglutinin H1 (09H1) at 2.9 Å, illustrating that the 09H1 is very similar to the 1918 pandemic HA (18H1) in overall structure and the structural modules, including the five defined antiboby (Ab)-binding epitopes. Our results provide an explanation as to why sera from the survivors of the 1918 pandemics can neutralize the 2009 S-OIV, and people born around the 1918 are resistant to the current pandemic, yet younger generations are more susceptible to the 2009 pandemic.
Animals ; Cloning, Molecular ; Crystallography, X-Ray ; Hemagglutinin Glycoproteins, Influenza Virus ; chemistry ; genetics ; immunology ; isolation & purification ; Influenza A Virus, H1N1 Subtype ; chemistry ; genetics ; immunology ; Models, Molecular ; Protein Conformation ; Swine ; virology

【Objective】 To compare the clinical application value of controllable negative pressure suction outer sheath and ordinary flexible endoscope outer sheath in flexible ureteroscopic lithotripsy with holmium laser in the treatment of renal calculi less than or equal to 2 cm in diameter. 【Methods】 A total of 85 patients with renal calculi were selected and randomly divided into negative pressure group (n=45) and ordinary group (n=40). The operation time, complications, infection indexes 2 h after operation, adverse reactions, treatment efficacy and stone-clearance rate were compared between the two groups. 【Results】 The sheath was successfully implanted and holmium laser lithotripsy was performed in both groups. The negative pressure group had significantly shorter operation time than the ordinary group [(43.3±4.9) min vs. (66.2±5.8) min, P<0.05] . There were 1 case of renal pelvis perforation and 1 case of ureteral laceration in the ordinary group (P>0.05). The increase of infection indexes (procalcitonin and leukocyte) 2 h after operation were significantly lower in the negative pressure group than in the ordinary group (P<0.05). The efficacy in the negative pressure group was 91.11% (41/45) and the stone-clearance rate was 95.56% (43/45), which were significantly better than those in the ordinary group (72.50% (29/40) and 80% (32/40), respectively. The total incidence of adverse reactions such as renal colic, gross hematuria and ureteral stone street was higher in the ordinary group than in the negative pressure group (P<0.05). 【Conclusions】 Controllable negative pressure suction sheath in flexible ureteroscopic lithotripsy is more effective, as the circulation perfusion keeps the operation field clear, reduces the operation time and improves the stone-clearance rate, while the negative pressure suction lowers the pelvis pressure to prevent infectious urine from entering the blood.

OBJECTIVETo explore the clinical characteristics and prognostic value of monosomal karyotype (MK) patients in adult acute myeloid leukemia (AML).

METHODSWe retrospectively studied 45 patients of MK⁺ in newly-diagnosed adult AML in our center from Oct 2000 to Dec 2012. Clinical characteristics, cytogenetic data and prognostic features were analyzed in the cohort of MK⁺ patients.

RESULTSMK was found in 45 patients (19.0%) of 237 newly-diagnosed adult AML with cytogenetic data available at diagnoses. Among these 45 cases, there were 28 male (62.2%) and 17 female (37.8%). Median age of MK⁺ patients at diagnose was 58(18-91) years old. The presence of -5(31.1%) and -7(17.8%) were the most common chromatid among MK⁺ AML patients. MK was much more prevalent among elderly patients. Among AML patients, the proportions of MK⁺ patients younger than 30, 30 to 59 and older than 60 years old groups were 11.5%, 17.7% and 22.4%, respectively. There was no difference between MK⁺ and MK⁻ patients in gender distribution (P=0.545). There was also no difference between MK⁺ and MK⁻ patients in the distribution of FAB castigation (P=0.239). Median survival of MK⁺ AML patients was 6.5 months. Cumulative 5-year overall survival (OS) of was 5.2%. Forty-three MK⁺ patients (43/45, 95.6%) also had a complex karyotype (CK). Two cases that did not meet the CK had not achieved complete remission (CR), and died within 6 months. There were 12 patients who were CK⁺ in 192 MK⁻ patients. The differences of OS and CR rates between MK⁺CK⁺ patients and MK⁻CK⁺ were statistically significant (P<0.05).

CONCLUSIONThe increased detection rate of MK with age was associated with lower CR and OS in AML patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chromosome Aberrations ; Female ; Humans ; Karyotyping ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; Male ; Middle Aged ; Monosomy ; Prognosis ; Remission Induction ; Retrospective Studies ; Young Adult