Objective To evaluate the therapeutic effect of autologous hematopoietic stem cell transplantation(AHSCT)on hematological malignancies and solid tumors.Methods Twenty patients with age from 18 to 50 years received AHSCT.Two or 3 of following agents,Cytarabine(Ara-C)3～4 g/m2,Cyclophosphamide(CTX)4～6 g/m2,Etoposide(VP-16)0.5～1.0 g/m2,Semustine(me-CCNU)300 mg/m2,Melphalan(Mel)140 mg/m2,Thiotep a(TSPA)600 mg/m2,Carboplatin(CBP)1.0 g/m2,Busulfan 16mg/kg,were combined as conditioning regimen in all patients.Among them 2 patients with ALL accepted additional total body irradiation(TBI).Results All the patients have reconstituted bone marrow hematopoiesis after transplantation.None of them had the transplantation-related mortality.Among 20 patients with CML and malignant lymphoma,15 achieved disease-free survival(DFS)with a median survival time of 39.5(2～109)months.Conclusion AHSCT might represent an effective approach to the treatment of some patients with chemosensitive solid tumor who are complete remission or part remission.It is suggested that the patients have got a obvious survival benefit from AHSCT.

Objective To observe the change of regulatory T cells expression in severely burned rats gut ,To investigate the effects of regulatory T cells on CD3+CD4+ /CD3+CD8+lymphocytes and its relation with gut-origin endotoxin translocation .Meth-ods Fifty SD male rats were randomly divided into normal control group(n=10)and burn model groups(n=40) .Rats were burned to achieve Ⅲ degree scalding ,and a 30% total body surface area(TBSA) burn model was made .Rats were sacrificed before(normal control group) and after 0 .5 ,1 ,2 ,4 burn hour(PBH groups) .Flow cytometry techniques were used for the detection of the expres-sions of regulatory T cells and CD3+CD4+ /CD3+CD8+ lymphocyte in intestinal lymph nodes which were separated .The dynamic turbidity method was used for detection of endotoxin levels in portal vein blood .Results The expression of regulatory T cells was negativelycorrelatedwithCD3+CD4+ /CD3+CD8+ lymphocyteratio(r= -0.827,P<0.01)inintestinallymphnodeofrats,while the regulatory T cells was positively correlated with ET levels in portal vein blood plasma .(r=0 .782 ,P<0 .01) .Conclusion The expression of the regulatory T cells in intestinal lymph node in severely burned rats was increased compared to that in normal con-trol group .Regulatory T cells suppressed the expression of intestinal T lymphocytes ,leading to gut immune inhibition .The translo-cation of intestinal endotoxin has a close relationship with regulatory T cells in severely burned rats .Regulatory T cells could have portal effects on intestinal immunity barrier .

Objective To evaluate the efficacy of noninvasive positive-pressure ventilation (NPPV) on acute respiratory failure (ARF) in elderly patients with severe community-acquired pneumonia (CAP).Methods 321 CAP patients with ARF aged over 65 years [(75.6±12.2) years old in averag] were randomly treated with NPPV (n=162) and the standard oxygen therapy (n=159).Intubation rate,ARF control rate and total mortality were compared between the two groups,and the risk factors were analyzed.Results 90％ of 321 patients presented with hypoxemic respiratory failure.Compared with standard therapy group,the intubation rate was lower in NPPV group (46.9％ vs.64.2％,x2=9.652,P＜0.01).However,there were no differences in ARF control rate(77.9％ vs.72.3％,x2 =1.274,P＞0.05),overall 30-day mortality and 90-day survival between the two groups.The overall mortality in NPPV group was higher in treatment failure cases than in treatment success cases (48.7％ vs.11.6％,x2=26.900,P＜0.01).The independent risk factors for death were treatment failure in NPPV,higher simplified acute physiology score assessment,old age and mutilobar infiltrate.Conclusions NPPV can decrease the intubation rate in CAP patients with acute hypoxemic respiratory failure,but the overall efficacy is not significant.Delayed intubation should be avoided when NPPV is to be applicated.

Objective To study the expressions of YKL-40 and IL-1β in the cartilage of knee osteoarthritis(KOA),and analysis the possible relationship between YKL-40,IL-1β in KOA.Methods Thirty-eight patients diagnosed with KOA were selected in this hospital as observation group.Then select 30 articular cartilage cases in the same period due to knee injury knee joint examina tion or treatment of knee joint fracture surgery patients,referred to as the control group.According to KOA radiation and arthroscopic grading standards,the observation group was divided into 16 cases of mild group,10 cases of moderate group,11 cases of severe groups.Compare the expression levels of all patients including YKL-40,interleukin-1β (IL-1β),IL 6,tumor necrosis factor-α (TNF-α),while recording Mankin score and cell mortality.Results Expression of YKL 40,IL-1β,IL-6,TNFα,Mankin scores and rate of cell death about observation group were significantly higher than control group,the indicators above in mild,moderate,severe group showed a trend of rising(all P＜0.05).And the expression levels of YKL-40 and IL-1β were significantly positive correlation (r=0.738,P=0.000).In addition, The expression levels of YKL-40 had relation with IL 6 (r=0.819,P=0.000),TNF-α (r=0.871,P=0.000) and Mankin score (r=0.832,P 0.000),cells mortality deposit (r=0.832,P=0.000).Conclusion Expression levels of YKL-40 and IL-1β were significantly increased in cartilage of knee osteoarthritis patients,and there showed a significant positive correlation between YKL-40 and IL-1β.

An HA-1-DC nucleic-acid vaccine was constructed to induce anti-leukemia effect after hematopoietic stem cell transplantation (HSCT). DCs were generated from HSCT donors in vitro, and its immunologic activity was assayed by using flow cytometry and mixed lymphocytes reaction. HA-1 gene was electroporated into the cultured DCs to construct a DC nucleic-acid vaccine. After transfection for 48 h, the expression of HA-1 protein could be detected by using Western blot. The DCs were cultured with syngenic lymphocytes to induce specific cytotoxic T lymphocytes (CTLs). The cytoxicity of the CTLs was detected by LDH assay. The results showed that The DCs derived from peripheral blood monocytes (PBMCs) expressed the phenotype of DCs, and were effective in stimulating proliferation of the allogenic lymphocytes. After electroporating for 48-h, HA-1 protein was detected by using Western blot. The cytotoxicty of inducing CTLs was higher than the control group. It was suggested that minor histocompatibility antigen HA-1 could be considered as a target of immunotherapy against leukemia after HSCT.

An HA-1-DC nucleic-acid vaccine was constructed to induce anti-leukemia effect after hematopoietic stem cell transplantation (HSCT). DCs were generated from HSCT donors in vitro, and its immunologic activity was assayed by using flow cytometry and mixed lymphocytes reaction.HA-1 gene was electroporated into the cultured DCs to construct a DC nucleic-acid vaccine. After transfection for 48 h, the expression of HA-1 protein could be detected by using Western blot. The DCs were cultured with syngenic lymphocytes to induce specific cytotoxic T lymphocytes (CTLs).The cytoxicity of the CTLs was detected by LDH assay. The results showed that The DCs derived from peripheral blood monocytes (PBMCs) expressed the phenotype of DCs, and were effective in stimulating proliferation of the allogenic lymphocytes. After electroporating for 48-h, HA-1 protein was detected by using Western blot. The cytotoxity of inducing CTLs was higher than the control group. It was suggested that minor histocompatibility antigen HA-1 could be considered as a target of immunotherapy against leukemia after HSCT.

As an important means of lung protective strategy, prone position ventilation (PPV) which can effectively shorten the time of mechanical ventilation, significantly reduce the mortality of patients with acute respiratory distress syndrome (ARDS), and is suitable for popularization and application in the ICU. However, some studies show that prolonged prone position can significantly increase the incidence of Stress injury, making it difficult to implement PPV in the practical level. In order to achieve the goal of safe and effective prevention of skin Stress injury, and to promote the correct implementation of PPV, this paper review the methods of preventing Stress injury in patients with PPV.

Objective:To investigate the correlation between the lipocalin-2 (LCN-2) level and white matter hyperintensities (WMHs) in patients with ischemic stroke.Methods:Consecutive patients with ischemic stroke admitted to the Department of Neurology, Jinling Hospital, Medical School of Nanjing University from September 2021 to November 2021 and whose duration from onset to hospitalization <14 d were prospectively enrolled. Enzyme-linked immunosorbent assay was used to detect the serum LCN-2. Fazekas scale was used to assess the severity of periventricular and subcortical WMHs. A total WMHs score ≥3 was defined as severe WMHs. Multivariate logistic regression analysis was used to determine the correlation between serum LCN-2 level and WMHs. Results:A total of 179 patients were enrolled, including 122 males (68.2%), aged 64.7±11.6 years. The median serum LCN-2 level was 387.1 g/L, and 86 patients (48.0%) had severe WMHs. Serum LCN-2 in the severe WMH group was significantly higher than that in the non-severe WMH group (505.3±342.4 g/L vs. 367.8±224.5 g/L; t=3.110, P=0.002). Multivariable logistic regression analysis showed that after adjusting for the relevant confounding factors, there was a significant correlation between higher serum LCN-2 and severe WMHs (odds ratio 2.32, 95% confidence interval 1.17-4.63; P=0.017) and higher total WMHs score (odds ratio 1.62, 95% confidence interval 1.12-2.35; P=0.011). Conclusion:Higher serum LCN-2 level is associated with severe WMHs in patients with ischemic stroke.

Objective:To ascertain the basic situation of radiotherapy in Fujian in 2016.Methods:Based on the unified questionnaire, the types and quantity of radiotherapy and its corollary equipment, the number of radiotherapy staff and the work for quality control were surveyed in the radiotherapy units in the whole province, and the data on patients undergoing radiotherapy and other types of patients were collected from 26 hospitals. The total number of radiotherapy patients in the whole province was estimated by the correlation analysis and multiple linear regression analysis.Results:Radiotherapy was performed in a total of 32 hospitals in Fujian province in 2016. Among them, there were 62 sets of radiotherapy equipment, 33 sets of the simulators, 57 sets of treatment planning systems and 762 workers. The total number of 15 156 radiotherapy patients in 26 hospital were available for the survey. Multiple linear regression models showed that the frequency of application of medical electron accelerator was positively correlated with number of outpatients, emergency patients and inpatients, number of radiotherapy staff, number of electron accelerators ( r=0.311, 0.893, 0.956, P<0.05). Meanwhile, the frequency of aterloading brachytherapy was positively correlated with number of outpatients, emergency patients and inpatients, number of radiotherapy staff, number of aterloading brachytherapy units ( r=0.307, 0.966, 0.988, P<0.05). The frequency of radiotherapy was 0.54 patients per 1 000 population in Fujian in 2016. The delivered dose calibration of accelerators was performed in all hospitals involved in line with the relevant regulations, but the number of quality control equipment for radiotherapy was insufficient, such as the QA beam checker or well-type ionization chamber. Conclusions:In recent years, the rapid development of radiotherapy has been seen in Fujian province. The radiotherapy management should focus on standardenized and improved quality control and regulation in future.

Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.