A 22﹣year﹣old female patient received methylprednisolone sodium succinate( methyl﹣prednisolone)for injection( 1 000 mg/d for 3 days and gradually reduced to 60 mg/d for maintenance therapy,IV infusion),immunoglobulin( 20 g/d,IV infusion),mouse nerve growth factor( 20 μg/d, intramuscular injection),vitamin B1(100 mg/d,intramuscular injection),and mecobalamin(1 mg/d,IV injection)for multiple sclerosis. Twelve days later,mouse nerve growth factor was temporarily discontinued and 7 days later,the drug was given again. On day 2 of retreatment,the patient developed conjunctival congestion. On day 3 of retreatment,red spots appeared on her chest,back,abdomen,and forearms. Then the rashes gradually increased,linked into pieces,and spread all over the body. Rashes partly formed blisters,blisters ulcerated,and epidermis exfoliated. It was considered that mouse nerve growth factor induced the toxic epidermal necrolysis. Then the drug was discontinued,the dose of methylprednisolone was increased to 500 mg/d,and at the same time,immunoglobulin,desloratadine,and fexofenadine were given. Twenty days later,the rashes subsided and pigmentation remained.

A 22﹣year﹣old female patient received methylprednisolone sodium succinate( methyl﹣prednisolone)for injection( 1 000 mg/d for 3 days and gradually reduced to 60 mg/d for maintenance therapy,IV infusion),immunoglobulin( 20 g/d,IV infusion),mouse nerve growth factor( 20 μg/d, intramuscular injection),vitamin B1(100 mg/d,intramuscular injection),and mecobalamin(1 mg/d,IV injection)for multiple sclerosis. Twelve days later,mouse nerve growth factor was temporarily discontinued and 7 days later,the drug was given again. On day 2 of retreatment,the patient developed conjunctival congestion. On day 3 of retreatment,red spots appeared on her chest,back,abdomen,and forearms. Then the rashes gradually increased,linked into pieces,and spread all over the body. Rashes partly formed blisters,blisters ulcerated,and epidermis exfoliated. It was considered that mouse nerve growth factor induced the toxic epidermal necrolysis. Then the drug was discontinued,the dose of methylprednisolone was increased to 500 mg/d,and at the same time,immunoglobulin,desloratadine,and fexofenadine were given. Twenty days later,the rashes subsided and pigmentation remained.

OBJECTIVE:To investigate the relationship between HLA-B*5801 gene polymorphism and allopurinol-induced ADR in the Han population of Hainan Province. METHODS:The in-situ hybridization fluorescence staining analysis technique was used to detect HLA-B*5801 allele of 149 inpatients receiving allopurinol in Hainan Provincial People's Hospital during Sept. 2015-Sept. 2017.They were divided into tolerance group and ADR group according to ADR.Woolf's formula was used to calculate OR. The correlation of HLA-B*5801 allele with the occurrence of allopurinol-induced ADR was analyzed. RESULTS:Of 149 patients,there were 133 cases in tolerance group,among which 17.29%(23/133)carried HLA-B*5801 allele.There were 16 cases in ADR group,among which 93.75%(15/16)carried HLA-B*5801 allele. Among 16 ADR patients,13 patients suffered from lesion of skin and its appendents;1 patient suffered from systemic damage;1 patient suffered from gastrointestinal systemic damage;1 patient suffered from central and peripheral nervous system damage. The risk of ADR in patients with HLA-B*5801 allele was significantly higher than patients without HLA-B*5801 allele(OR:71.74,95%CI:9.02-570.55,P<0.000). The lesion of skin and its appendents was strongly associated with HLA-B*5801 allele(OR:57.39,95%CI:7.11-463.50,P<0.000). CONCLUSIONS:HLA-B*5801 allele is strongly associated with allopurinol-induced ADR. It is suggested that HLA-B*5801 allele of Han patients should be detected before taking allopurinol,which helps to reduce the incidence of allopurinol-induced ADR.

A 58-year-old male patient received aspirin enteric-coated tablets 200 mg and rosuvastatin calcium 10 mg once daily by mouth,IV infusions of butylphthalide and sodium chloride injection 100 ml (containing butylphthalide 25 mg and sodium chloride 0.9 g)twice daily and troxorutin brain protein hydrolysate 10 ml once daily for acute ischemic stroke. Seven days later,laboratory tests showed blood urea 6.9 mmol/L,serum creatinine (Scr)131 μmol/L,and blood cystatin C 1.54 mg/L. Kidney injury induced by butylphthalide and sodium chloride injection was considered. Butylphthalide and sodium chloride injection was stopped but the other drugs as well as Xueshuantong for injection (注射用血栓通)and Corbrin capsule (百令胶囊)were given. Laboratory tests showed blood urea 6.2 mmol/L,Scr 104 μmol/L,and blood cystatin C 1.05 mg/L 6 days later and then blood urea 5.9 mmol/L,Scr 101 μmol/L,and blood cystatin C 1.00 mg 2 months later.

A 58-year-old male patient received aspirin enteric-coated tablets 200 mg and rosuvastatin calcium 10 mg once daily by mouth,IV infusions of butylphthalide and sodium chloride injection 100 ml (containing butylphthalide 25 mg and sodium chloride 0.9 g)twice daily and troxorutin brain protein hydrolysate 10 ml once daily for acute ischemic stroke. Seven days later,laboratory tests showed blood urea 6.9 mmol/L,serum creatinine (Scr)131 μmol/L,and blood cystatin C 1.54 mg/L. Kidney injury induced by butylphthalide and sodium chloride injection was considered. Butylphthalide and sodium chloride injection was stopped but the other drugs as well as Xueshuantong for injection (注射用血栓通)and Corbrin capsule (百令胶囊)were given. Laboratory tests showed blood urea 6.2 mmol/L,Scr 104 μmol/L,and blood cystatin C 1.05 mg/L 6 days later and then blood urea 5.9 mmol/L,Scr 101 μmol/L,and blood cystatin C 1.00 mg 2 months later.

OBJECTIVE:To provide reference for the supply of emergency drugs. METHODS:The data of emergency drugs in the inpatients of our hospital were collected from hospital information system during 2012-2016,including the proportion and age of emergency patients,drug,clinical departments and disease types. The trend of emergency drugs was analyzed by using SPSS 16.0 software. RESULTS:The proportion of emergency patients and discharged patients were increasing year by year. The number of patients in <10 year-old and 10-19 year-old showed a declining trend year by year. The number of patients in 30-39 year-old,50-59 year-old and >60 year-old showed an increasing trend year by year. Among emergency drugs,the use frequency of Heparin sodium injection,Dexamethasone sodium phosphate injection and Flumethasone injection showed a declining trend year by year;the use fre-quency of Hemagglutination for injection,Penehyclidine ether injection,Atracurium besylate injection and Propofol injection showed an increasing trend year by year. Among clinical department,the number of pediatric patients showed a declining trend year by year;the number of patients in obstetrics department,emergency department,cardiology department,micro hand surgery department and pediatric surgery department showed an increasing trend year by year. Among emergency disease types,the number of patients with re-spiratory system disease,infectious and parasitic diseases showed a declining trend year by year;the number of patients with circula-tion system disease,injury and poisoning,certain other consequences of external factors,digestive system diseases,pregnancy,child-birth and puerperium disease as well as some cases originated in the perinatal period showed an increasing trend year by year. CON-CLUSIONS:With the change of the proportion,age and disease type of emergency patients,the type and utilization rate of emergen-cy drugs have changed. It is necessary to adopt effective measures to guarantee the supply of emergency drugs.

Objective To investigate the clinicopathological characteristics,treatment,prognostic factors of primary small intestinal lymphoma (PSIL).Methods The clinical data of 68 patients with PSIL who were admitted to the Cancer Hospital of Tianjin Medical University from November 1999 to July 2009 were retrospectively analyzed.The diagnostic workup before operation included abdominal ultrasound,computed tomography (CT) scan of the abdomen,small intestinal barium radiography,endoscopy examination and laboratory examination.The patients with local PSIL underwent radical surgery,patients who were not eligible for radical surgery received palliative treatment,and then accurate staging was done according to Ann-Arbor system for gastrointestinal lymphoma,and chemotherapy was applied according to the condition of patients.The patients were followed up by letters,telephone and outpatient care till July 2012.Factors might have influence on the prognosis were analyzed by the Kaplan-Meier method and Log-rank test.COX regression model were used for univariate and multivariate analysis,respectively.Results The major symptoms of PSIL included abdominal pain (69.1％,47/68) and weight loss (29.4％,20/68).All of the 68 patients underwent small intestinal barium radiography and endoscopy examination,and 15 and 11 cases were definitely diagnosed as with PSIL.Abdominal mass were detected by abdominal ultrasound in 38 of 45 cases.Positive results were found in 30 cases by CT and 5 cases by positron emission tomography (PET)-CT.PSIL mainly involved ileum (73.5％,50/68),13 PSILs were located at the jejunum and 5 at the duodenum.Of all the 68 patients,64 were with B-cell subtype PSIL and 4 were with T-cell subtype PSIL.Most tumors belonged to stages Ⅰ and Ⅱ (66.2％,45/68).All of the 68 patients were treated with surgical procedure,including 51 patients received radical resection and 17 patients had palliative resection.After operation,4-8 cycles of chemotherapy were applied in 57 patients.Seven patients received COP regimen,50 received CHOP regimen (10 patients with positive expression of CD20 received R-CHOP regimen simutaneously),the remaining 11 patients did not receive chemotherapy.Sixty-four patients were followed up,and the follow-up rate was 94.1％ (64/68).The median follow-up time was 40 months (range,3-132 months).The median survival time was 40.5 months.The 1-,3-,and 5-year overall survival rates were 78.1％,62.2％ and 59.7％,respectively.The prognosis of patients with B-cell subtype PSIL,in stage Ⅰ-Ⅱ and received operation + chemotherapy was superior to those who were with T-cell subtype PSIL,in stage Ⅲ-Ⅳ and received operation (x2=22.459,45.535,15.782,P ＜ 0.05).The results of univariate analysis showed that level of LDH,pathological subtype,clinical stage,presence of systemic symptom,treatment modality,radical surgery and lymphatic metastasis were risk factors for prognosis (x2=7.245,22.459,45.535,5.796,15.782,45.926,9.214,P ＜ 0.05).The results of multivariate analysis revealed B cell phenotype,stage Ⅰ-Ⅱ and surgery + chemotherapy were independent prognostic factors for survival (RR =7.133,5.304,0.256,95％ CI:1.634-31.130,1.498-18.781,0.095-0.691,P ＜ 0.05).Conclusions The major symptoms of PISL include abdominal pain and weight loss.Definite diagnosis of PSIL depends on endoscopy and imaging examination.PSIL mainly involves ileum.Surgery based treatment is the preferred option,and the combined treatment of rituximab with chemotherapy may improve the survival.B-cell phenotype,early clinical stage (Ⅰ-Ⅱ) and surgical resection plus chemotherapy are independent prognostic factors for better survival.

OBJECTIVETo introduce the recent developments in cancer immunoinformatics with an emphasis on the latest trends and future direction.

DATA SOURCESAll related articles in this review were searched from PubMed published in English from 1992 to 2013. The search terms were cancer, immunoinformatics, immunological databases, and computational vaccinology.

STUDY SELECTIONOriginal articles and reviews those were related to application of cancer immunoinformatics about tumor basic and clinical research were selected.

RESULTSCancer immunoinformatics has been widely researched and applied in a series of fields of cancer research, including computational tools for cancer, cancer immunological databases, computational vaccinology, and cancer diagnostic workflows. Furthermore, the improvement of its theory and technology brings an enlightening insight into understanding and researching cancer and helps expound more deep and complete mechanisms of tumorigenesis and progression.

CONCLUSIONCancer immunoinformatics provides promising methods and novel strategies for the discovery and development of tumor basic and clinical research.

Objective To investigate the clinical features and prognosis of recurrent gastric cancer. Methods The clinical data of 147 patients with recurrent gastric cancer was reviewed. Risk factors correlated with tumor recurrence and recurrent intervals were studied by logistic regression analysis. Survival analyses and comparisons were performed using Kaplan-Meier plots, the log rank test and the Cox proportional hazards model. Results Patients were divided into an early recurrence group consisting of 86 patients (recurred within one year after surgery) and a late recurrence group of 61 patients (recurred one year or more after surgery). There were significant difference in size of primary tumor, Borrmann stage, type of gastrectomy, T stage, N stage, TNM stage between the two groups(P ＜0.05). Multivariate analysis showed that the TNM stage and N stage independently influenced the recurrent time ( P ＜ 0. 05 ). In univariate survival analysis, post-gastrectomy chemotherapy(P ＜0. 05) , T stage (P ＜0. 05) , N stage(P ＜0.01) , TNM stage ( P ＜ 0. 01) , recurrence-free interval (P ＜ 0. 01) and reoperation (P ＜ 0.01) were significantly correlated with the prognosis. In multivariable analysis, TNM stage(P ＜0. 01) , recurrence-free interval ( P ＜ 0. 05 ) and reoperation ( P ＜ 0. 05 ) were independent factors predicting recurrence. Conclusions The TNM stage and N stage were the important factors predicting the time of recurrence after curative resection for gastric cancer. Patients with recurrent gastric cancer have poor prognosis and reoperation was associated with an improved survival in patients with recurrent gastric cancer.

OBJECTIVE:To investigate the effects of pravastatin on serum levels of CRP and TNF-? in patients with diabetic nephropathy and study its possible mechanism in the treatment of diabetic nephropathy. METHODS:28 patients with diabetic nephropathy were treated with provastatin plus routine therapy (trial group),another 28 patients with diabetic nephropathy were treated with routine therapy alone (control group). Serum levels of CRP and TNF-? in the two groups were detected after treatment for 24 weeks. RESULTS:The total effect rate in the trial group was 67.9% versus 42.9% in the control group(P