Objective:To analyze the clinical value of nutritional risk index (NRI) in assessing the prognosis of patients with multiple myeloma (MM).Methods:The clinical data from 120 patients with MM who received treatment at Xi'an International Medical Center Hospital between October 2019 and November 2020 were retrospectively analyzed. The patients were divided into a high NRI group (NRI ≥ 83.5, n = 76) and a low NRI group (NRI < 83.5, n = 44) based on their NRI values. The survival outcomes of the two groups were compared, and a receiver operating characteristic curve was used to evaluate the prognostic value of NRI in patients with MM. Results:Compared with the high NRI group, the low NRI group had a later stage according to the International Staging System, with lower proportions of patients having serum C-reactive protein (≤ 10 mg/L), hemoglobin (≤ 120 g/L), and albumin (≤ 35 g/L) [24 (54.55%) vs. 56 (73.68%), 38 (86.36%) vs. 45 (59.21%), 43 (97.73%) vs. 46 (60.53%), χ2 = 4.59, 7.21, 20.13, all P < 0.05]. The 1-year, 2-year, and 3-year survival rates in the low NRI group were significantly lower than those in the high NRI group (χ2 = 4.22, 37.51, 20.38, all P < 0.05), and the median overall survival was also significantly lower in the low NRI group (χ2 = 68.04, P < 0.05). Receiver operating characteristic curve analysis indicated that the area under the curve for NRI predicting 3-year survival in MM patients was 0.796. The predictive value was highest when NRI > 82.35, with a sensitivity of 92.98% and specificity of 53.97%. Conclusion:The NRI score can effectively assess the nutritional status of newly diagnosed MM patients and has significant clinical value for the early prediction of death within 3 years.

Objective:To analyze the clinical value of nutritional risk index (NRI) in assessing the prognosis of patients with multiple myeloma (MM).Methods:The clinical data from 120 patients with MM who received treatment at Xi'an International Medical Center Hospital between October 2019 and November 2020 were retrospectively analyzed. The patients were divided into a high NRI group (NRI ≥ 83.5, n = 76) and a low NRI group (NRI < 83.5, n = 44) based on their NRI values. The survival outcomes of the two groups were compared, and a receiver operating characteristic curve was used to evaluate the prognostic value of NRI in patients with MM. Results:Compared with the high NRI group, the low NRI group had a later stage according to the International Staging System, with lower proportions of patients having serum C-reactive protein (≤ 10 mg/L), hemoglobin (≤ 120 g/L), and albumin (≤ 35 g/L) [24 (54.55%) vs. 56 (73.68%), 38 (86.36%) vs. 45 (59.21%), 43 (97.73%) vs. 46 (60.53%), χ2 = 4.59, 7.21, 20.13, all P < 0.05]. The 1-year, 2-year, and 3-year survival rates in the low NRI group were significantly lower than those in the high NRI group (χ2 = 4.22, 37.51, 20.38, all P < 0.05), and the median overall survival was also significantly lower in the low NRI group (χ2 = 68.04, P < 0.05). Receiver operating characteristic curve analysis indicated that the area under the curve for NRI predicting 3-year survival in MM patients was 0.796. The predictive value was highest when NRI > 82.35, with a sensitivity of 92.98% and specificity of 53.97%. Conclusion:The NRI score can effectively assess the nutritional status of newly diagnosed MM patients and has significant clinical value for the early prediction of death within 3 years.

Objective:To investigate the effect of autologous hematopoietic stem cell transplantation (auto-HSCT) bridging to chimeric antigen receptor T cell (CAR-T) immunotherapy for follicular lymphoma (FL) transformed to B-lymphoblastic leukemia/lymphoma (B-LBL).Methods:The diagnosis and treatment of 1 patient with FL transformed to B-LBL admitted to the First Hospital of Soochow University in August 2020 were retrospectively analyzed and the literature was reviewed.Results:The male patient was 65 years old, and was diagnosed as FL (stage Ⅳ group A, FL international prognostic index -1 score 3 points, high-risk group) in August 2020. And then he was given 6 courses of RB (rituximab combined with bendamustine) regimen, with complete remission (CR) at mid-term and end-stage PET-CT, followed by regular maintenance therapy with rituximab every 2 months, and disease progressed after 4 courses of maintenance therapy. According to the results of histopathology and bone marrow aspiration in December 2021, he was diagnosed B-LBL involving the bone marrow. Partial remission was achieved after induction therapy with zanubnulindb combined with hyper CVAD (cyclophosphamide + doxorubicin + vindesine + dexamethasone) regimen, followed by auto-HSCT bridging to CAR-T treatment targeting CD19 and CD22, which proceeded smoothly with cytokine release syndrome grade 0, immune effector cell-associated neurotoxicity syndrome grade 0. The patient successfully underwent hematopoietic reconstruction and orally taken ibrutinib after discharge. PET-CT indicated CR 2 months after transplantation and he was still in disease-free survival state.Conclusions:The prognosis of FL transformed to B-LBL is poor, and auto-HSCT bridging to CAR-T can improve the prognosis and prolong the survival time of patients who cannot undergo allogeneic hematopoietic stem cell transplantation.

Objective To assess the accuracy of histological type and molecular subtype observed in preoperative 11-gauge vacuum-assisted core needle biopsy(VACNB) specimens in breast cancer.Methods Patients diagnosed by preoperative 1 l-gauge VACNB and received subsequent open excisional biopsy (OEB) from Mar 1 st 2014 to Mar 31 st 2015 were included.Kappa testing was used to test the concordance rate of histological type,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor 2(Her-2),Ki-67 and molecular subgroups between VACNB and paired OEB specimens.ER,PgR,Her-2,and Ki-67 were determined by immunohistochemistry (IHC).Patients with Her-2 IHC (+ +) were further examined by FISH.Molecular subtypes were classified as follows:LuminalA,LuminalB,Triple Negative,and Her-2 positive.Results There were 36 patients analyzed(32 of them had invasive breast cancer).Between VACNB and paired OEB specimens,concordance rate of histological type,ER,PR,Her-2,Ki-67 and molecular group were 94.4％ (κ =0.934),96.9％ (κ =0.904),87.5％ (κ =0.710),100％ (κ =1.000),84.4％ (κ =0.570),78.1％ (κ =0.621).No significant difference was detected in the expression of ER,PR and Ki-67 between VACNB and OEB specimens according to paired t-test results.Concordance rate of each molecular subtype between VACNB and OEB specimens were 100％ for Her-2 positive subtype,94.1％ for LuminalB subtype,50％ for LuminalA,and 33.3％ for TNBC.When the threshold for ER/PR positivity was upgraded from ≥1％ to ≥10％ and Ki-67 cutoff value to≥20％,the concordance rate for ER,PR,Ki-67 and molecular subtype reached to 100％,93.8％,87.5％,81.3％.Conclusions 11 G vacuum-assisted core needle biopsy was accurate in determining histological type and molecular subtype in breast cancer.

OBJECTIVETo research the effects of moschus, borneol, styrax and benzoinum on the structure and function of blood brain barrier in cerebral ischemia-reperfusion injury model rats.

METHODFocal middle cerebral artery occlusion (MCAO) was introduced as an in vivo ischemic model in rats. After 2 h MCAO, nylon suture was pulled up 1 cm to give blood reperfusion. After 22 h reperfusion, all animals were decapitated. The ultramicrostructure of blood brain barrier of ischemia hemisphere side in fronto-parietal cortex region by transmission electron microscope, and the content of VEGF and MMP-9 in ischemia side brain tissue were measured by ELISA.

RESULTIn model and solvent group rats, the capillary endothelium cells, astro-glial cells and nerve cells in ischemia hemisphere side in fronto-parietal region were emerged in different degree compared with sham-operated groups, which exhibited tight junction between endothelial cells being opened, basal lamina being dissolved, and permeability increasing, and cellularedema. In borneol (0.2 g x kg(-1)) group rats, the structure of three kinds of cells were nearly normal, which tight junction structure was clear, rough endoplasmic reticulum and polyribosome could be found in cytoplasm. In moschus (66.6 mg x kg(-1)) group rats, the structure of capillary endothelium cells and astrocytes were nearly normal as well as the basal lamina, but the electrons in neurons was maldistribution. In styrax (1.332 g x kg(-1)) group rats, astrocytes were nearly normal, while capillary endothelial cells and neurons exhibited oedema in different degrees. And the basal lamina was discontinuous, augmentation of cell spaces in endothelial cells increased the permeability, some endoplasmic reticulum broadened and ribosome ablated. In benzoinum (1.0 g x kg(-1)) group rats, oedema of capillary endothelial cells and astrocytes was significant, basal lamina broke. Meanwhile endoplasmic reticulum broadened as vacuole, the number of ribosome in rough endoplasmic reticulum decreased, crista mitochondriales in some neurons disappeared as vacuole which hint oedema happened. Results also showed that borneol decrease the level of VEGF in ischemia side brain tissue significantly, while has little influence on the level of MMP-9. Moschus showed the tendency to decrease the level of VEGF and MMP-9 in ischemia side brain tissue.

CONCLUSIONAromatic resuscitation drugs showed the protection effect on blood brain barrier in cerebral ischemia-reperfusion injury rats, which the protection effect of moschus and borneol were better than that of styrax and benzoinum. The mechanism of protection effect maybe related to decrease the level of VEGF and MMP-9.

Animals ; Benzoin ; pharmacology ; Blood-Brain Barrier ; drug effects ; metabolism ; ultrastructure ; Bornanes ; pharmacology ; Brain Ischemia ; drug therapy ; metabolism ; Disease Models, Animal ; Fatty Acids, Monounsaturated ; pharmacology ; Infarction, Middle Cerebral Artery ; drug therapy ; metabolism ; Male ; Matrix Metalloproteinase 9 ; drug effects ; metabolism ; Neuroprotective Agents ; pharmacology ; Plant Extracts ; pharmacology ; Rats ; Reperfusion Injury ; drug therapy ; metabolism ; Styrax ; chemistry ; Vascular Endothelial Growth Factor A ; drug effects ; metabolism

Objective To measure the operative length of the radioactive source with RL_HZJ18 afterloading machine.Methods The ways of direct measurement and treatment plan are both collected to measure.Results Both of the ways can measure the operative length,and the error of length can be accurate to 1mm.Conclusion The way is simple,practical,good maneuverability,it is worth the trial and promotion.