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 analyze the association of cytogenetic abnormalities with the prognosis of chronic myeloid leukemia (CML) patients in tyrosine kinase inhibitors (TKI) era. Methods: Karyotype analysis of chromosome G-banding was carried out in 387 newly diagnosed CML patients by short-term culture of bone marrow cells. The correlation of cytogenetic abnormalities and CML progression was explored in combination with ABL tyrosine point mutations. Result: Of 387 patients with positive BCR-ABL fusion gene assayed by fluorescence in situ hybridization (FISH) technique, 94.1% (364/387) patients were Ph positive and 5.9% (23/387) Ph negative; 320 patients (87.9%) had a translocation t (9;22) (q34;q11) and 5 (1.4%) a variant translocation t (v;22) . Additional cytogenetic aberrations (ACA) at diagnosis were found in 10.7% (39/387) Ph⁺ patients, major route ACA in 22 (56.4%) cases and minor route ACA in 15 (38.5%) cases and 2 patients (5.1%) lacked the Y chromosome (−Y) ; 23.4% (71/303) patients occurred ACA during TKI treatment and the most frequent abnormalities were abnormal chromosome numbersd, which were likely associated with high proportion of disease progression (χ²=168.21, P<0.001) and ABL tyrosine point mutations (χ²=29.04, P<0.001) . Newly diagnosed CML-CP patients with t (9;22) (q34;q11) had a longer event-free survival (EFS) and disease-free survival (DFS) rates than that of patients with ACA (P=0.037; P=0.003) , while the overall survival (OS) had no significant differences (P=0.209) . As for CML-CP patients that occurred ACA during TKI therapy would have a marked low OS, EFS and DFS (all P<0.001) compared with no ACA occurred patients. Survival of advanced patients that occurred ACA were dramatically reduced. Conclusion ACA often emerged during the disease progress in CML patients, regular and timely detection of chromosomes karyotype and ABL tyrosine point mutations during TKI treatment was important for therapeutic evaluation, progress and prognosis of CML.

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 investigate the clinical efficacy of arthroscopic limited incision of the articular capsule to repair the glenoid labrum in the treatment of borderline developmental dysplasia of the hip (BDDH) complicated with labral tear.Methods:A retrospective study was conducted to analyze the data of 18 patients with BDDH complicated with labral tear who had been admitted to Department of Orthopaedics, The Second Hospital Affiliated to Suzhou University from January 2016 to December 2019 (observation group). There were 12 males and 6 females with an age of (41.8 ± 8.5) years. Simultaneously, another 18 patients were selected as the control group whose hip development was normal but age and gender were matched with those in the observation group. There were 9 males and 9 females with an age of (43.5 ± 10.3) years. Both groups were treated by arthroscopic limited incision of the articular capsule to repair the glenoid labrum. The 2 groups were compared in terms of modified Harris hip score (MHHS), Hip Outcome Score Activities of Daily Living Subscale (HOS-ADL), and visual analogue scale (VAS).Results:There was no significant difference in the demographic data like age, gender ratio, body mass index, severity of labral tear or time from injury to operation between the 2 groups, indicating comparability between groups ( P>0.05). The observation and control groups were followed up for (38 ± 7) and (43 ± 6) months, respectively. For the observation and control groups, respectively, MHHS was (97.1 ± 3.3) points and (95.4 ± 4.2) points, HOS-ADL (92.6 ± 2.8) points and (91.4 ± 4.1) points, and VAS (0.6 ± 0.5) points and (1.0 ± 0.8) points, all showing no significant difference between groups ( P>0.05). Conclusion:In the treatment of BDDH patients complicated with labral tear, simple arthroscopic limited incision of the articular capsule to repair the glenoid labrum can lead to the same good medium-term efficacy as it can in those with normal hip development.

Polycyclic aromatic hydrocarbons (PAHs) are compounds with more than two benzene rings, widely exist in the environment, and can affect human health in various ways. Previous studies on the health effects of PAHs mainly focused on their carcinogenicity, teratogenicity, and effects on pulmonary diseases, cardiovascular diseases, etc. In recent years, increasing attention has been paid to the negative influence of PAHs to inflammatory skin diseases (especially psoriasis, atopic dermatitis, and lupus erythematosus). This review summarizes recent research advances in the role of PAHs in the occurrence and development of inflammatory skin diseases.

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:To evaluate a novel distraction reductor in the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution.Methods:From January 2019 to December 2020, 27 patients with unstable distal radius fracture complicated with metaphyseal volar comminution were treated at Department of Orthopaedics, Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences. They were 6 males and 21 females, with an age of (69.4±9.4) years. All fractures were unilateral and closed, involving the right side in 17 cases and the left side in 10 cases. All patients were treated by internal fixation with an anatomical locking plate through the volar approach and the novel distraction reductor was used to reduce the fracture ends. Regular imaging examinations were performed to evaluate the reduction, maintenance and union of fractures after surgery. One year after operation, the curative efficacy was assessed by evaluation of the range of wrist motion, Disabilities of the Arm, Shoulder and Hand (DASH) score, Gartland-Werley score and Bartra radiology score.Results:All the operations went on successfully with a duration of (92.3±8.9) min. All the incisions healed primarily. The follow-up time was (15.9±2.9) months. The radial height, palmar tilt, ulnar inclination and articular surface step-off immediately after operation [(11.23±1.51) mm, 12.10°±3.44°, 20.54°±3.44°, and (0.95±0.42) mm] were not significantly lost compared with those one year after operation [(11.22±1.55) mm, 12.07°±3.44°, 20.51°±3.33°, and (0.93±0.40) mm] (all P>0.05). One year after operation, the range of wrist motion was good with dorsiflexion of 59.7°±5.5°, palm flexion of 63.0°±9.1°, pronation of 66.5°±5.5°, supination of 61.2°±5.6°, radial deviation of 22.7°±4.8°, and ulnar deviation of 30.3°±6.1°; DASH score was 13.5±5.5; Bartra radiology score was 88.6±6.5, giving an excellent and good rate of 88.9% (24/27);Gartland-Werley score was 2.7±2.1, giving an excellent and good rate of 92.6% (25/27). Follow-ups observed no poor fracture healing, internal fixation failure, tendon or nerve injury or traumatic arthritis. Conclusion:In the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution, the novel distraction reductor can lead to ideal reduction of displaced fractures and effectively correct the shortening caused by volar cortex comminution to achieve satisfactory functional effects in clinic.

Objective To explore the mechanisms of Buyang Huanwu Decoction(BYHWD)in reducing oxidative stress levels to protect the blood-brain barrier(BBB)in cerebral ischemia/reperfusion injury(CIRI)rats.Methods A middle cerebral artery occlusion/reperfusion(MCAO/R)model in rats was established via wire embolization method.PeriCam PSI laser speckle flow imaging was applied to detect whether the model was successfully established.Neurological deficits in the rats were evaluated by Zea Longa score,and histopathological changes in the rat brain were observed by HE staining.The degree of brain edema was detected by the dry and wet weight method.BBB permeability was detected by Evans blue staining,and ultrastructural changes to the BBB were observed by transmission electron microscopy.The levels of ROS,MDA and SOD activities,which are related to oxidative stress,were detected using kits.The expression levels of matrix metalloproteinase-9(MMP-9)were detected by immunohistochemical staining and Western blot.The expression levels of Occludin,ZO-1,and Claudin-5 tight junction proteins were determined via immunofluorescence and Western blot.Results BYHWD reduced neurological deficit scores,alleviated brain histopathological damage,alleviated BBB structural disruption,prolonged the appearance of dense regions in the tight junction structure,attenuated edema of the brain on the ischemic side,and reduced BBB permeability in MCAO/R rats.BYHWD decreased the levels of ROS and MDA,increased the activity of SOD,decreased the expression levels of MMP-9,and increased the expression levels of Occludin,Claudin-5 and ZO-1.Conclusions BYHWD can increase BBB tight junction protein expression levels,reduce the permeability of the BBB,protect the ultrastructure of the BBB,and reduce brain edema,and its mechanisms may be related to its antioxidant activity and inhibition of MMP-9 activation.

Objective To compare anesthetic effects between erector spinae plane block(ESPB)and intercostal nerve block(ICNB)in thoracoscopic lung wedge resection guided by surgical pleth index(SPI).Methods A total of 46 patients who underwent thoracoscopic lung wedge resection in Wenzhou People's Hospital from July 2020 to June 2022 were selected and divided into ICNB group and ESPB group according to random number table method,with 23 cases in each group.Remifentanil infusion rate,propofol dosage and intraoperative vital signs were compared between two groups.Results The intraoperative remifentanil infusion rate in ESPB group was significantly lower than that in ICNB group(P<0.05).There was no significant difference in intraoperative propofol dosage between two groups(P>0.05).The SPI,bispectral index and mean arterial pressure in ESPB group during lung wedge resection were significantly lower than those in ICNB group(P<0.05).There was no significant difference in heart rate between two groups(P>0.05).Conclusion Under the guidance of SPI,patients undergoing thoracoscopic lung wedge resection with preoperative ESPB had low opioid consumption and stable vital signs.

Objective To explore the effect of physical exercise on semen quality in order to provide basic data and theoretical basis for the improvement of male reproductive health.Methods A cross-sectional study was conducted on 1 059 males who visited the Reproductive Medicine Center of Shandong Maternal and Child Health Hospital for medical treatment and physical examination during July 2022 and April 2023.Their demographic data and physical exercise data were surveyed with questionnaires.Total sperm count,sperm concentration,total sperm motility,forward movement and normal sperm morphology were analyzed with computer aided analysis.Logistic regression model and multiple linear regression model were applied to analyze the effects of physical exercise on semen quality.Results After adjustment for confounding factors such as age,body mass index,alcohol consumption and smoking,logistic regression analysis showed that the risk of abnormal semen quality was increased in patients with moderate and heavy exercise intensity(OR=2.103,OR=2.229).Compared with the participants with physical exercise ≤10 min per session,those with＞20 min per session had a lower risk of abnormal semen quality(OR=0.357,0.256,0.289 for exercise time for＞20～30,＞30～60,＞60 min,respectively).There was no statistical significance between physical exercise frequency and semen quality(P＞0.05).The participants having exercise well were at a lower risk for abnormal semen quality(OR=0.711).Multiple linear regression analysis revealed that the frequency of physical exercise was an influencing factor of sperm concentration(β=7.474,95％CI:4.800～10.149,P＜0.05);the time of physical exercise per session was an influencing factor for total sperm count(β=20.632,95％CI:7.634～33.629);the intensity of physical exercise(β=-1.461,95％CI:-2.392～-0.530)and time of physical exercise per session(β=2.608,95％CI:1.404～3.812,P＜0.05)were influencing factors for percentage of forward motility sperm(P＜0.05);and physical exercise intensity(β=-1.934,95％CI:-3.238～-0.630),time of physical exercise per session(β=4.211,95％CI:2.525～5.897)and frequency of physical exercise(β=-2.008,95％CI:-3.480～-0.536)were influencing factors of total sperm motility(P＜0.05).Conclusion Physical exercise may affect semen quality,greater intensity of physical exercise may be a risk factor for abnormal semen quality,and longer physical exercise time may be related to improving semen quality.Therefore,proper physical exercise can help improve semen quality.