0.1 ?mol?L-1), inducing differentiation through enhancement of melanogenesis and increase of the activity of tyrosinase at lower doses(

Objective:To investigate the effect of prognostic nutrition index (PNI) and clinical characteristics on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 236 patients with DLBCL treated in the Affiliated Hospital of Xuzhou Medical University from November 2014 to December 2018 were retrospectively analyzed. X-Tile software and restricted cubic spline (RCS) were used to determine the best cut-off values of PNI, age and hemoglobin; Cox proportional hazard regression model was used for univariate and multivariate analyses; Kaplan-Meier method was used to analyze the overall survival (OS) of patients, and log-rank test was also performed.Results:One-hundred and fifteen of the 236 patients (48.7%) died, with a median OS time of 32 months. The 3-year OS rate was 46%, and the 5-year OS rate was 36%. The best cut-off value of PNI was 49. There was a significant non-linear relationship between PNI and the risk of poor prognosis of DLBCL ( χ2=34.64, P < 0.01); the analysis of the dose-response relationship showed that with the change of PNI, the correlation strength of the risk of poor prognosis declined non-linearly. The best cut-off value of age was 63 years old, and the correlation strength between age and the risk of poor prognosis of DLBCL showed a non-linear upward trend ( χ2=14.86, P=0.022). The best cut-off values of hemoglobin calculated by X-Tile software were 93 g/L and 129 g/L. Multivariate analysis showed that PNI, central nervous system involvement, liver involvement, age, hemoglobin, international prognostic index (IPI) score, and bulky disease were independent influencing factors of OS in DLBCL patients (all P < 0.05). In patients with germinal center B-cell-like (GCB) subtype, bcl-2-positive and bcl-6-positive, there were statistical differences in the 3-year OS rate of patients with PNI < 49 and PNI ≥ 49 (all P < 0.05). Conclusion:PNI has a certain value in the prognosis assessment of DLBCL patients, and PNI ≥ 49 indicates that the patient has a good prognosis.

Objective To investigate the clinical efficacy of intratympanic corticosteroids(ITS)and hyperbaric oxygen therapy(HBOT)in patients with idiopathic sudden sensorineural hearing loss(ISSNHL)who had failed systemic corticosteroid(SS)treatment.Methods ISSNHL patients admitted to the Department of Otolaryngology,First People's Hospital of Linping District of Hangzhou city from January 2020 to January 2023 were retrospectively collected.According to the treatment plan,patients with ISSNHL were divided into SS group,HBOT group,and ITS group.The changes in hearing level[purity hearing threshold mean(PTA)]and hearing gain of ISSNHL patients before treatment(T0),day 5(T1)and after 3 months of treatment(T2)were observed and compared,and the total effective rate of treatment in different groups was compared.Univariate analysis was used to explore the influencing factors of the efficacy of patients with different treatment modalities of ISSNHL.Results A total of 156 ISSNHL patients were included,including 70 in the SS group,33 in the HBOT group and 53 in the ITS group.At T0,there was no significant difference in PTA among the three groups of patients(P>0.05).At T2,the level of PTA in the three groups of ISSNHL patients was significantly lower than that before treatment(P<0.05).The levels of PTA in the HBOT group and ITS group were significantly lower than those in the SS group(P<0.05).The level of PTA in the HBOT group was significantly lower than that in the ITS group(P<0.05).The hearing gain of the HBOT group and the ITS group was significantly higher than that of the SS group(P<0.05),and the hearing gain of the HBOT group was significantly higher than that of the ITS group(P<0.05).The total effective rate of HBOT group was significantly higher than that of ITS group(P<0.05),and the total effective rate of ITS group was significantly higher than that of SS group(P<0.05).In addition,vertigo was an influencing factor for poor hearing recovery in ISSNHL patients regardless of treatment regimen(P<0.05).Conclusion Both ITS and HBOT can improve the treatment efficiency of ISSNHL patients who have failed SS treatment and promote hearing recovery in ISSNHL.Compared with IST,HBOT has more significant efficacy,and it is recommended that clinical treatment be prioritized.Vertigo is an influencing factor for poor hearing recovery in patients with ISSNHL who have failed SS treatment,and should be focused on in clinical practice.

Objective:To investigate the bacterial distribution of secondary infection and the status of drug resistance in hospitalized patients of hematology department.Methods:The clinical data of 1 125 inpatients in the Hematology Department of the Affiliated Hospital of Xuzhou Medical University from January 2015 to December 2019 were retrospectively analyzed, and the distribution of infectious pathogens and the status of drug resistance of these inpatients were analyzed.Results:A total of 9 335 microbial samples from 1 125 inpatients were submitted for examination, among which 1 349 were positive samples. Among 1 349 positive samples, the gram-negative bacteria-positive samples accounted for 66.4% (895/1 349) and the gram-positive bacteria-positive samples accounted for 33.7% (454/1 349); the blood samples accounted for 44.7%(603/1 349), the sputum samples accounted for 33.9% (457/1 349), and the urine samples accounted for 9.4%(127/1 349). The isolated bacteria whose proportion ranked as the top 3 were Escherichia coli (31.0%), Staphylococcus aureus (21.0%) and Klebsiella pneumoniae (18.0%). The drug resistance rate of Escherichia coli to ceftriaxone was as high as 77.2%, and that of Staphylococcus aureus and coagulase-negative Staphylococcus to benzoxicillin was 58.2% and 66.7%, but both had no resistance to vancomycin.Conclusions:There are a wide variety of infectious pathogens in hospitalized patients of hematology department, and the Escherichia coli and Klebsiella pneumonia are predominant. More attention should be paid to antibiotic prescribing training for clinicians to optimize and standardize the use of antibiotics.

Objective:To explore the prognostic influencing factors of adult lymphoma-associated hemophagocytic syndrome (LAHS) based on multicenter data.Methods:The clinical data of 86 LAHS patients diagnosed in 9 medical centers of Huaihai Lymphoma Working Group from January 2015 to August 2020 were retrospectively analyzed. The optimal cut-off value of continuous variables was obtained based on MaxStat algorithm. Cox proportional hazard regression model was used for univariate and multivariate analyses. Kaplan-Meier method was used for survival analysis, and log-rank test was performed.Results:Among the 86 adult LAHS patients, 50 (58.1%) were males and 36 (41.9%) were females, the median age of the patients was 57 years old (19-76 years old), and the median overall survival (OS) time was 1.67 months (95% CI 0.09- 3.24 months). The most common pathologic type was diffuse large B-cell lymphoma (58 cases, 67.44%). Based on MaxStat algorithm, the optimal cut-off values of age, albumin, serum creatinine, lactate dehydrogenase, fibrinogen and platelet count were 64 years old, 30.1 g/L, 67 μmol/L, 1 045 U/L, 4.58 g/L and 72×10 9/L, respectively. Multivariate analysis showed that patient's age, lactate dehydrogenase, albumin and fibrinogen levels were independent influencing factors for OS (all P < 0.05). Conclusions:LAHS is dangerous and progresses quickly. Patients with age ≥ 64 years old, lactate dehydrogenase ≥ 1 045 U/L, fibrinogen ≥ 4.58 g/L and albumin < 30.1 g/L have poor survival.

Objective:Factors influencing the prognosis of hemophagocytic lymphohistiocytosis (HLH) in adults were analyzed based on multicentric data.Methods:Clinical data of 124 adult patients with HLH diagnosed in eight medical centers in the Huaihai Lymphoma Working Group from March 2014 to July 2020 were collected. The optimal truncation value of continuous variables was obtained based on the Maxstat algorithm, X-Tile software, and restricted cubic spline. Cox proportional risk regression model was used to construct the adult HLH risk prediction model, and the visualization of the model was realized through the histogram. The bootstrap resampling method was used to verify the model, C-index and calibration curve was used to verify the histogram, and the prediction accuracy was checked. Kaplan-Meier analysis was used to calculate the survival rate and draw the survival curve. Furthermore, the differences between groups were tested by log-rank.Results:The median age of the 124 patients was 55 (18-84) years, including 61 (49.19%) males. The most common etiology was infection. Serum ferritin increased in 110 cases (88.71%) , hepatosplenomegaly in 57 cases (45.97%) . Of the 124 patients, 77 (62.10%) died, and the median survival time of the patients was 7.07 months. Univariate results showed that the prognosis of adult HLH was influenced by sex, age, fibrinogen, serum creatinine, alanine aminotransferase, and albumin ( P<0.05) . The results of multivariate analysis showed that gender, platelet, albumin, alanine aminotransferase, and treatment regimens were independent influencing factors for prognosis. Based on the above five risk factors, the prediction model of the histogram was established, and the C-index of the model was 0.739. Finally, the calibration chart showed good consistency between the observed and predicted values of HLH. Conclusion:The prognosis of the adult hemophagocytic syndrome is influenced by many factors. Gender, platelet, albumin, alanine aminotransferase, and treatment regimens are independent risk factors. Therefore, the established histogram provides a visual tool for clinicians to evaluate the prognosis of adult HLH.

BACKGROUNDBy synthesizing results from primary studies, systematic review can provide empirical information of concerned problems. This study aimed to review the available surveillance data from studies reporting the contamination surveillance of food lead in China.

METHODSRelevant studies were identified by systematically searching Chinese Biological Medicine Database and China National Knowledge Infrastructure using the key term of "lead" for surveillance data published in Chinese between 2006 and 2012. To avoid potential selection bias, all articles were evaluated by two independent reviewers, and the disagreements were resolved by discussion or the third author was asked to arbitrate.

RESULTSAmong 269 identified publications on surveillance data of lead in food, 43 articles met the defined inclusion criteria. The food samples were divided into 11 groups (cereal grains and pulses, fish, eggs, vegetables, meat, edible fungi, milk and dairy products, fruits, offal, tea and preserved egg). Surveillance data of publications were reviewed to calculate the weighted mean and rate exceeding maximum levels. Our results indicated that the highest lead concentration was 1.937 mg/kg in tea. The total percentage of samples exceeding the maximum levels was 5.57%. Dietary exposure to lead was assessed by combining the weighted mean concentration of surveillance data with national consumption data in 2002. In this review, dietary intake of lead was 1.232 µg/kg b.w./day.

CONCLUSIONFurther control measures should be taken to reduce exposure to lead, from both dietary and non-dietary sources.

China ; Food Contamination ; analysis ; Humans ; Lead ; analysis ; Risk Assessment