OBJECTIVETo investigate the significance of H3K27me3 and its methyltransferase EZH2 in predicting the short-term and long-term outcome of newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL).

METHODSThe paraffin wax speciments of 102 DLBCL patients in Fujian Medical University Cancer Hospital were collected. The expression of H3K27me3, EZH2 and BCL-2 protein were detected using tissue array made by tissue microarray(TMA) technique and immunohistochemistry method. The evaluation data after clinical treatment and follow-up results were collected and combined with expression levels of H3K27me3, EZH2 and BCL-2 detected by tissue array, then on the basis of these data, the survival of patients was analyzed by Kaplan-Meier method, the correlation of EZH2 with H3K27me3 and BCL-2 was analyzed by pearson correlation test, the correlation of above mentioned indicators with different therapeutic efficacy was analyzed by spearman correlation test. The relationship of H3K27me3 and EZH2 expression as well as co-expression of H3K27me3 and EZH2 with the therapeutic efficacy and prognosis of patients were compared.

RESULTSA total of 61.8% patients showed EZH2 high expression which positively correlated with high expression of H3K27me3 and BCL-2. The complete remission (CR) and overall remission (OR) rates in H3K27me3 high expression and co-expression of H3K27me3 EZH2 groups were lower than those in low expression groups (P<0.001), moreover OS and PFS rates also were lower than those in low expression (P<0.001). In the RCHOP subgroup, the patients with EZH2 low expression showed significantly better CR, OR OS and PFS in comparison with those of patients with higher expression (P=0.003,P=0.019).

CONCLUSIONPart of DLBCL patients with H3K27me3 high expression or coexpression of both H3K27me3 and EZH2 exhibit a worse prognosis in comparison with those patients with H3K27me3 low expression or without coexpression. The patients with EZH2 low expression usually responde well to RCHOP regimen in the short-term or long-term survival.

OBJECTIVETo compare the clinical effects between anterior cervical discectomy and fusion(ACDF) combined with anterior cervical corpectomy and fusion(ACCF) and cervical posterior single open-door laminoplasty with mini-titanium plate fixation in treating three-segment cervical spondylotic myelopathy.

METHODSThe clinical data of 63 patients (39 males and 24 females) with three-segment cervical spondylotic myelopathy underwent surgical treatment from March 2014 to March 2016 were retrospectively analyzed. Among them, 43 cases were treated by ACDF combined with ACCF(anterior group), and 20 cases were treated by cervical posterior single open-door laminoplasty with mini-titanium plate fixation(posterior group). Operative time, intraoperative blood loss, postoperative complications were compared between two groups. And according to JOA score to evaluate the clinical effect.

RESULTSAll the patients were follow-up from 16 to 40 months with an average of 25.8 months. Operative time of anterior group and posterior group were (123.70±6.21) min and(118.70±5.41) min, respectively, there was no significant difference between two groups(>0.05). Intraoperative blood loss of anterior group and posterior group were (85.23±7.51) ml and (107.18±9.41) ml, respectively, there was significant difference between two groups(<0.05). In anterior group, axial symptoms occurred in 6 cases, dysphagia in 1 case, and no C₅ nerve root palsy, hoarseness and choking cough were found, the incidence rate of complication was 16.3%(7/43); and in posterior group, axial symptoms occurred in 5 cases, C5 nerve root palsy in 1 case, and no dysphagia, hoarseness and choking cough were found, the incidence rate of complication was 30.0%(6/20); there was significant defference in incidence rate of complication between two group(<0.05). At 1 week after operation and final follow-up, the JOA scores of anterior group were obviously better than that of posterior group(<0.05).

CONCLUSIONSAbove-mintioned two surgical treatment for cervical spondylotic myelopathy can provide instantly stability, the method of ACDF combined with ACCF was obviously better that of the method of cervical posterior single open-door laminoplasty in intraoperative blood loss, the incidence rate of complications, clinical effect.Thus, for the treatment of three-segment cervical spondylotic myelopathy, the method of ACDF combined with ACCF would be firstly chosen.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.

Along with the increase of clinical application, the safety of traditional Chinese medicine gained more and more attentions. In particular, the safety evaluation of Chinese medical injections has become a mandatory task should be completed by pharmaceutical companies under the supervision of China Food and Drug Administration(CFDA). Due to the weak foundation of previous studies, the safety issues of Chinese medical injections have not been fully understood, and lack of scientific and rational risk management programs. Clinical safety centralized monitoring(CSCM) is an important method for post-market safety evaluation of Chinese medicine. Due to the lack of appropriate norms and procedures, the quality of similar research is uneven, and the results vary. Combined with practical experience with experts' suggestions, we developed this expert consensus on the design and implementation of CSCM from three stages (design, implementation and report) with 20 technical points, which will provide technical support for future CSCM studies.

OBJECTIVETo evaluate the efficacy and safety of cyclophosphamide as a second-line drug in the treatment of children with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.

METHODSSix children with anti-NMDAR encephalitis, who showed poor response to steroids and intravenous immunoglobulin, were given cyclophosphamide as a second-line immunotherapy. Follow-up was performed to evaluate the efficacy and safety of cyclophosphamide.

RESULTSAfter first-line immunotherapy for 1-4 weeks, the six patients had reduced psychiatric symptoms, seizures, and involuntary movements; three patients had an improved level of consciousness and were able to make simple conversations. However, all the patients still showed slow response, as well as cortical dysfunction symptoms such as aphasia, alexia, agraphia, acalculia, apraxia, and movement disorders. The six patients continued to receive cyclophosphamide as a sequential therapy. They were able to answer simple questions 7 days after treatment. Three school-aged patients were able to make simple calculation, had greatly improved reading and writing ability, and almost recovered self-care ability 2-3 weeks later. The cognitive function of the six patients was almost restored to the level before the onset of disease, and their living ability returned to normal 2-3 months later. During the treatment period, there were no adverse reactions or abnormal results of routine blood test and liver and kidney function tests.

CONCLUSIONSChildren with anti-NMDAR encephalitis should be given appropriate immunotherapy as soon as possible. Cyclophosphamide as a sequential therapy has good efficacy and safety.

Adolescent ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis ; drug therapy ; physiopathology ; psychology ; Child ; Child, Preschool ; Cognition ; Cyclophosphamide ; therapeutic use ; Female ; Humans ; Immunotherapy ; Male

The study aims to investigate the effect of Ligustri Lucidi Fructus on cytochrome c oxidase(COX) activity in rat hepatic tissues and explore its possible mechanism of DNA methylation. Male SD rats received aqueous extract of Ligustri Lucidi Fructus (2.0，6.0 g•kg⁻¹) by intragastric administration for 30 d. After the rats were sacrificed, hepatic tissues of rats were taken to detect COX activity, protein concentration of COX4I1, TET1 and DNMT3A protein levels, mRNA expression levels of Cox4i1, Dnmt3a and Tet1, and determine the DNA methylation frequency of Cox4i1.Results showed that both low and high doses of Ligustri Lucidi Fructus could significantly increase COX activity and concentration of COX4I1(P<0.05), with a decreasing tendency of both TET1 protein and DNMT3a protein expression； however, mRNA expression levels of Cox4i1, Dnmt3a and Tet1 were not significantly changed by Ligustri Lucidi Fructus. In addition, DNA methylation frequency of Cox4i1 in high dose group showed a declining tendency as compared with the blank control group, but without significant difference.These results indicated that Ligustri Lucidi Fructus had promotive effect on hepatic COX activity in rats, which may be achieved by increasing protein content of COX4I1. Moreover, a decreased tendency of DNMT3A protein could be one of the reasons for the lower trend of Cox4i1 methylation rate. In addition, Ligustri Lucidi Fructus may regulate the expression levels of DNMT3A and TET1 in the same direction and its mechanism is not clear.

The aim of this paper was to explore the effects of Frankincense and Myrrh essential oil on transdermal absorption in vitro of Chuanxiong, and to investigate the possible penetration mechanism of their essential oil from the perspective of skin blood perfusion changes. Transdermal tests were performed in vitro with excised mice skin by improved Franz diffusion cells. The cumulative penetration amounts of ferulic acid in Chuanxiong were determined by HPLC to investigate the effects of Frankincense and Myrrh essential oil on transdermal permeation properties of Chuanxiong. Simultaneously, the skin blood flows were determined by laser flow doppler. The results showed that the cumulative penetration amount of ferulic acid in Chuanxiong was (8.13±0.76) μg•cm⁻² in 24 h, and was (48.91±4.87), (57.80±2.86), (63.34±4.56), (54.17±4.40), (62.52±7.79) μg•cm⁻² respectively in Azone group, Frankincense essential oil group, Myrrh essential oil, frankincense and myrrh singly extracted essential oil mixture group, and frankincense and myrrh mixed extraction essential oil group. The enhancement ratios of each essential oil groups were 7.68, 8.26, 7.26, 8.28, which were slightly greater than 6.55 in Azone group. In addition, as compared with the conditions before treatment, there were significant differences and obvious increasing trend in blood flow of rats in Frankincense essential oil group, Myrrh essential oil group, frankincense and myrrh singly extracted essential oil mixture group, and frankincense and myrrh mixed extraction essential oil group when were dosed at 10, 20, 30, 10 min respectively, indicating that the skin blood flows were increased under the effects of Frankincense and Myrrh essential oil to a certain extent. Thus, Frankincense and Myrrh essential oil had certain effect on promoting permeability of Chuanxiong both before and after drug combination, and may promote the elimination of drugs from epidermis to dermal capillaries through increase of skin blood flow, thus enhancing the transdermal permeation amounts of drugs.

OBJECTIVETo retrospectively investigate the clinical effect of the rivet-assisted hollow screw in the treatment of posterior cruciate ligament avulsion fracture.

METHODSTotal 49 patients with knee cruciate ligament avulsion fracture in the ending point of the ligament from January 2010 to December 2014 were divided into the treatment group and the control group. Thirty-one patients in treatment group were treated with rivet-assisted double cannulate nail, including 13 males and 18 females, ranging in age from 38 to 51 years old, with a mean of (40.6±5.1) years old; according to Meyers classification, 23 cases of type 2, 8 cases of type 3; 5 patients were caused by the low energy injury and 26 patients were caused by the high energy injury. Eighteen patients in control group were treated with double gold hollow screw fixation, including 5 males and 13 females, ranging in age from 36 to 52 years old, with an average age of (4.16±4.7) years old; according to Meyers classification, 14 cases of type 2 and 4 cases of type 3;2 patients were caused by the low energy injury and 16 patients were caused by the high energy injury. The operation time, postoperative complications, fracture healing time and the last AKS scoring system were compared between the two groups.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 24 months, with an average of 14.2 months. The patients in treatment group had no displacement of fracture fragments and internal fixation failure. The results of AKS score:pain was 48.1±1.5, activity was 21.3±2.7, stability was 20.9±2.5, walking ability was 47.3±1.9, under the stairs ability was 43.4±2.1, the total score was 190.7±2.9. There were 2 cases in control group had fracture fragment displacement and 1 patient had nail withdraw. The results of AKS score:pain was 40.1±2.2, activity was 20.1±0.2, stability was 18.1±3.2, walking ability was 46.3±1.7, under the stairs ability was 40.2 ±1.3, the total score was 180.2±1.4. Therefore, the comparison of the above indicators, the results of the treatment group were better than those of the control group.

CONCLUSIONSRivet-assisted hollow screw fixation in the treatment of cruciate ligament avulsion fracture in the ending, has some advantages such as follows:accurate reduction, less postoperative complications and better postoperative knee function recovery, therefore it is an effective way to treat posterior cruciate ligament avulsion fracture.

OBJECTIVETo study the effect of Bushen Huoxue decoction on calcification of cartilage endplate in lumbar vertebrae.

METHODSSix healthy male gerbils with 2-month-old were selected as normal control group, and 24 7-month-old healthy male gerbils were fed to 12-month-old to establish the aged gerbil model. Thirty gerbils were randomly divided into five groups as follow: the normal control group (=6), model group (=6, normal saline 4 ml/kg, intragastric 30 d), Bushen Huoxue low dose group(=6, 1.9× 10⁻ ³ ml/g given Bushen Huoxue recipe orally, 30 d), Bushen Huoxue middle dose group(=6, 3.8× 10⁻ ³ ml/g given Bushen Huoxue recipe orally, 30 d), Bushen Huoxue high dose group(=6, 7.6× 10⁻ ³ ml/g given Bushen Huoxue recipe orally, 30 d), the intervention group administered for 1.36 g from 7-month-old age, 30 d. The animals were sacrificed at the age of 2 months in the normal control group and 12 months of age in the other groups. The morphology of the lumbar vertebral cartilage endplate, the area of vascular bud, the ratio of non-calcified/calcified layer were analysis by HE chromosome visual method. The expression of type X collagen and BMPs in cartilage endplates were detected by rabbit monoclonal immunohistochemical staining.

RESULTSThe relative area of the vascular buds cartilage endplate measurements showed that compared with the model group, middle dose group and normal control group increased (<0.05), high and low dose groups all had different degrees of increase, but no statistical significance(>0.05). The ratio of cartilage endplate thickness of non-calcified/calcified showed that compared with the model group, Bushen Huoxue middle dose, normal control group increased, with statistical significance(<0.05), and high and low dose groups all had different degrees of increase, but there were no statistical significance(>0.05). Compared with the model group, the expression of type X collagen in the cartilage endplate of the normal group, the Bushen Huoxue low, middle and high dose groups decreased, and had statistical significance(<0.01); compared with the model group, the expression of BMPs in the normal group, Bushen Huoxue middle dose group increased, with statistically significant(<0.01), while the high and low dose groups increased in different degrees, but there was no statistical significance(>0.05).

CONCLUSIONSBushen Huoxue prescription can delay the calcification of cartilage endplate in the process of aging, suggesting that it can be used as a preventive medicine for early disc degeneration.