Objective:To investigate the diagnostic value of plasma cytokines such as interleukin (IL)-2, IL-6 and interferon (IFN)-γ in non-Hodgkin lymphoma (NHL).Methods:A retrospective case-control study was conducted. A total of 48 NHL patients admitted to the Second Affiliated Hospital of Xuzhou Medical University between January 2020 and December 2022 were selected as NHL group, and another 34 healthy people who underwent physical examimation during the same period were selected as the healthy control group. The levels of IL-2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor (TNF) - α and IFN-γ in the plasma of patients at first admission and healthy subjects during physical examination were detected by using flow cytometry. The differences in general data and all cytokines levels of both groups were compared. The collinearity stepwise screening was made in 7 cytokines levels, and the screened variables were included in multivariate binary logistic regression model. Plasma cytokines with independent effects on the pathogenesis of NHL were screened. Taking local biopsy, histopathological examination or immunohistochemical examination as the gold standard, the receiver operating characteristic (ROC) curves of individual and combined diagnosis of NHL based on the selected cytokines were drawn to judge the diagnostic effect of all indicators on NHL.Results:There were 32 males (66.7%) and 16 females (33.3%) in NHL group, with the median age [ M ( Q1, Q3)] of 56.50 (45.75, 67.50) years; there were 28 males (82.4%) and 6 females (17.6%) in the healthy control group, with the median age of 52.00 (47.50, 55.50) years. There were no statistically significant differences in age and gender composition between the 2 groups (all P > 0.05). The levels of IL-2 [1.44 (1.36, 1.85) pg/ml vs. 1.19 (0.86, 1.68) pg/ml] and TNF-α [3.46 (2.68, 4.06) pg/ml vs. 2.23 (1.52, 3.46) pg/ml] in NHL group were higher than those in the healthy control group, and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in IL-4, IL-6, IL-10, IL-17, IFN-γ levels (all P > 0.05). According to collinear stepwise screening of independent variables, IL-4 and TNF-α were excluded from 7 cytokines, and the other 5 cytokines were included in multivariate logistic regression model, and the result showed that the decreased level of IL-2 ( OR = 0.20, 95% CI: 0.08-0.53, P = 0.001) and the increased levels of IL-6 ( OR = 1.18, 95% CI: 1.04-1.33, P = 0.009) and IFN-γ ( OR = 1.26, 95% CI: 1.08-1.46, P = 0.003) were independent risk factors for the onset of NHL. The results showed that the area under the curve of IL-2, IL-6, IFN-γ and the combination of 3 indexes for the diagnosis of NHL was 0.760 (95% CI: 0.651-0.870), 0.595 (95% CI: 0.468-0.722), 0.508 (95% CI: 0.373-0.642), 0.847 (95% CI: 0.763-0.930), and the optimal cut-off value of the combination of 3 indexes was 0.730 which was calculated by logistic regression model formula; the corresponding sensitivity and specificity were 70.2% and 94.1%, respectively. Conclusions:The decreased level of IL-2 and increased levels of IL-6 and IFN-γ at initial diagnosis are risk factors for the onset of NHL. The combined detection of the 3 indexes shows a good value in the diagnosis of NHL.

Tuberculosis （TB） and human immunodeficiency virus infection / acquired immune deficiency syndrome （HIV/AIDS） are both serious global public health threats. Early detection of infected persons and/or patients through TB/HIV bi-directional screening is crucial for prevention and control strategy in China and globally. In recent years， with the promotion and application of new TB and HIV detection technologies worldwide， TB/HIV bi-directional screening technologies and strategies have made remarkable changes. This expert consensus introduces the significance and challenges of TB/HIV bi-directional screening， summarizes important progress of research and applications， and makes recommendations on screening measures and procedures to further strengthen TB/HIV bi-directional screening in China.

Objective:To investigate the clinical features and therapeutic efficacy of patients with hereditary leiomyomatosis and renal cell carcinoma(RCC) syndrome-associated RCC (HLRCC-RCC) in China.Methods:The clinical data of 119 HLRCC-RCC patients with fumarate hydratase (FH) germline mutation confirmed by genetic diagnosis from 15 medical centers nationwide from January 2008 to December 2021 were retrospectively analyzed. Among them, 73 were male and 46 were female. The median age was 38(13, 74) years. The median tumor diameter was 6.5 (1.0, 20.5) cm. There were 38 cases (31.9%) in stage Ⅰ-Ⅱand 81 cases (68.1%) in stage Ⅲ-Ⅳ. In this group, only 11 of 119 HLRCC-RCC patients presented with skin smooth muscle tumors, and 44 of 46 female HLRCC-RCC patients had a history of uterine fibroids. The pathological characteristics, treatment methods, prognosis and survival of the patients were summarized.Results:A total of 86 patients underwent surgical treatment, including 70 cases of radical nephrectomy, 5 cases of partial nephrectomy, and 11 cases of reductive nephrectomy. The other 33 patients with newly diagnosed metastasis underwent renal puncture biopsy. The results of genetic testing showed that 94 patients had FH gene point mutation, 18 had FH gene insertion/deletion mutation, 4 had FH gene splicing mutation, 2 had FH gene large fragment deletion and 1 had FH gene copy number mutation. Immunohistochemical staining showed strong 2-succinocysteine (2-SC) positive and FH negative in 113 patients. A total of 102 patients received systematic treatment, including 44 newly diagnosed patients with metastasis and 58 patients with postoperative metastasis. Among them, 33 patients were treated with tyrosine kinase inhibitor (TKI) combined with immune checkpoint inhibitor (ICI), 8 patients were treated with bevacizumab combined with erlotinib, and 61 patients were treated with TKI monotherapy. Survival analysis showed that the median progression-free survival (PFS) of TKI combined with ICI was 18 (5, 38) months, and the median overall survival (OS) was not reached. The median PFS and OS were 12 (5, 14) months and 30 (10, 32) months in the bevacizumab combined with erlotinib treatment group, respectively. The median PFS and OS were 10 (3, 64) months and 44 (10, 74) months in the TKI monotherapy group, respectively. PFS ( P=0.009) and OS ( P=0.006) in TKI combined with ICI group were better than those in bevacizumab combined with erlotinib group. The median PFS ( P=0.003) and median OS ( P=0.028) in TKI combined with ICI group were better than those in TKI monotherapy group. Conclusions:HLRCC-RCC is rare but has a high degree of malignancy, poor prognosis and familial genetic characteristics. Immunohistochemical staining with strong positive 2-SC and negative FH can provide an important basis for clinical diagnosis. Genetic detection of FH gene germ line mutation can confirm the diagnosis. The preliminary study results confirmed that TKI combined with ICI had a good clinical effect, but it needs to be confirmed by the results of a large sample multi-center randomized controlled clinical study.

Angiopoietin-like 4(ANGPTL4)is one of the angiopoietin family members and plays a regulatory role in lipid metabolism,glucose homeostasis,inflammatory signal transduction,angiogenesis and vascular permeability.Inflammatory reaction in tumor microenvironment regulates tumor progression,and tumor angiogenesis plays a vital role in tumor growth and metastasis,so ANGPTL4 is closely related to tumor occurrence and development.Many studies have shown that ANGPTL4 plays an important regulatory role in tumor growth,anoikis resistance,tumor angiogenesis and tumor metastasis.This paper reviews the role of ANGPTL4 in tumor progression.

Objective To explore the clinical application value of second-generation dual-source CT combined with intelligent modulation and iterative reconstruction in emergency aortic dissection imaging.Methods A total of 40 emergency patients with clinical suspected aortic dissection were included in this study.Conventional scanning was performed in the control group,and large-pitch intelligent modulation and iterative reconstruction were performed in the test group.The mean CT value,mean noise,signal noise ratio(SNR),contrast noise ratio(CNR),effective dose,image quality and aortic root image quality were evaluated and analyzed.Results Totally 40 patients successfully completed CT aortic dissection imaging.There was no difference in image quality between the two groups (P＞ 0.05).The quality of aortic root images in the test group was better than that in the control group,and the difference was statistically significant(x2=22.556,P＜0.05).The mean CT value and mean noise of aorta in the control group were slightly higher than those in the test group.However,SNR and CNR in the test group were higher than those in the control group,and the difference was statistically significant (t =-21.042,-15.924,8.530,11.495,P＜0.05).The effective dose of the control group [(10.59±3.89)mSv] was significantly higher than that [(6.39±0.81) mSv] of the test group,the difference was statistically significant (t =-12.327,P＜0.05).Conclusions The combined intelligent modulation technique and iterative reconstruction technique with dual-source CT large pitch scanning can meet the requirements of image quality and reduce the effective dose,and can be used as a conventional imaging method for emergency CT of aortic dissection.

Objective To assess the value of cardiac magnetic resonance (CMR) imaging in left ventricular structure and function in patients with end stage renal disease (ESRD).Methods Twenty-five patients with ESRD and 10 healthy subjects underwent CMR.Left ventricular end diastolic volume(EDV),end-diastolic diameter(EDD),end-systolic volume(ESV),end-systolic diameter(ESD),stroke volume(SV),ejection fraction(EF),LVM and interventricular septum (IVS) thickness were measured and compared.The parameters from CMR and 2DTTE were compared.Results The EF in patients with ESRD was significantly lower than that in controls (P＜0.001),while ESV,ESD,IVS and LVM were respectively higher than these in controls (P＜0.05).There was no significant difference (P＞0.05) in ESV between CMR and 2DTTE,but EF of CMR was significantly higher than this of 2DTTE (P＜0.05).There was no significant difference (P =0.296) in left ventricular systolic functional category.Bland-Altman plots showed a good agreement between the two methods.Conclusion CMR is a helpful tool to assess left ventricular structure and function in patients with ESRD.

Objective To quantitatively analyze the mRNA expression level of lymphoid enhance factor 1 (LEF-1) in bone marrow mononuclear cells of patients with acute myeloid leukemia (AML) at intermediate-risk after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to measure the expression level of LEF-1 gene in AML patients at intermediate-risk after initial diagnosis and chemotherapy, and its relationship with effectiveness and survival were analyzed. Results The LEF-1 mRNA level in preliminarily diagnosed patients with AML was significantly higher than that in control arm [0.00519 (0.00015-0.09207) vs. 0.00101 (0.00009-0.00233)], and the difference was statistically significant (u=134.50, P<0.01). The LEF-1 mRNA level in patients after chemotherapy was significantly declines as compared to that in patients before chemotherapy [0.00107 (0.00008 - 0.00744) vs. 0.00519 (0.00015 - 0.09207)], and the difference was statistically significant (u= 317.00, P< 0.01) and LEF-1 mRNA expression level before chemotherapy in complete remission (CR) patients was significantly higher than that in non-CR patients [(0.01108 (0.00164 - 0.09207) vs. 0.00110 (0.00015 - 0.00916)], and the difference was statistically significant (u=19.00, P<0.01). High LEF-1 expression predicted a significantly better overall survival in AML patients with intermediate-risk cytogenetics (χ2= 4.549, P= 0.033). Conclusions LEF-1 may be involved in the development and progression of AML at intermediate-risk patients and is closely related to tumor burden and treatment efficacy. LEF-1 may be a good predictor of better prognosis and a novel target for therapeutic effect.

Objective To investigate the mRNA level of lymphoid enhancing factor-1 ( LEF-1) in bone marrow mononuclear cells after the initial diagnosis and chemotherapy of patients with multiple myeloma (MM) and its clinical significance. Methods The LEF-1 mRNA of target gene in 42 MM patient was detected by real-time fluorescence quantitative polymerase chain reaction (RTQ-PCR), and 20 patients without hematological disease were enrolled as the healthy controls. Results The LEF-1 mRNA median level in previously diagnosed MM patients was significantly higher than that in the healthy controls [0.01068 (0.00017 - 0.14100) vs. 0.00101 (0.00009 - 0.002326)], and the difference was statistically significant (U = 91.00, P< 0.001); The LEF-1 mRNA median level in MM patients after chemotherapy was declined compared with the patients before chemotherapy [0.00011 (0.00001 - 0.01548) vs. 0.01068 (0.00017 -0.14100)], and the difference was statistically significant (U = 343.0, P< 0.001). The LEF-1 mRNA median level of MM patients after chemotherapy in progression of disease (PD) group was higher than that in the non-PD groups [0.08386 (0.00288 - 0.14100) vs. 0.003454 (0.000156 - 0.05660)], and the difference was statistically significant (U = 343.0, P< 0.001). The overall survival (OS) rate in the high LEF-1 expression group was shorter than that in the low LEF-1 expression group for MM patients in the initial diagnosis (47.6%vs. 65.5 %, χ2 = 3.931, P= 0.0414). Conclusion LEF-1 may be involved in the occurrence and development of MM, which has a potential to become an indicator of evaluating the poor prognosis and PD of MM patients, and could be served as a novel therapy target for the treatment of MM.

Objective To quantitatively analyze the mRNA and protein expression level of a proliferation-inducing ligand (APRIL) and investigate its clinical significance in peripheral blood mononuclear cells and plasma from newly diagnosed patients with B-cell chronic lymphocytic leukemia (B-CLL).Methods The mRNA of the target gene in 32 B-CLL patients and 15 health controls was quantified with real-time fluorescence quantitative polymerase chain reaction (RFQ-PCR) and protein by enzyme-linked immunosorbent assay (ELISA).Results APRIL mRNA was assayed with RFQ-PCR,the intra-and inter-batch reproducibility showed the coefficient of variation (CV) were 1.69 ％-6.98 ％ and 6.49 ％-10.27 ％,respectively.The expressions of APRIL mRNA and protein in patients with B-CLL were significantly higher than those in control (P ＜ 0.05),and significant difference was noted among the comparable stages in the arms (P ＜ 0.05).The expression of APRIL mRNA and protein in TDI (treatment-demand-indicator) arm was significantly higher than those in non-TDI arm (P ＜ 0.05).Conclusions APRIL may be involved in the formation and development of B-CLL and be an influence factor for disease staging.Thus,APRIL may be a prognostic indicator as well as the therapy target for the disease.

Objective To investigate the effects of arsenic trioxide plus thalidomide on immune function of patients with myelodysplastic syndrome (MDS).Methods Fifty-seven MDS patients (Low risk,medium risk and high risk) and 30 healthy volunteers were selected as our subjects.Thirty-four cases with medium risk Ⅱ and high risk MDS patients were randomly divided into A and B groups.Seventeen MDS patients in A group were treated with arsenic trioxide plus thalidomide,and 17 MDS patients in B group were treated with low-dose cytarabine.Lymphocyte subsets in peripheral blood were examined by flow cytometry (FCM).The adverse effect of arsenic trioxide and thalidomide were recorded.Results Compared with control group,the number of T lymphocytes(CD3 +),B lymphocytes (CD3-CD19 +) and NK cell (CD3-(CD16 CD56) +) of patients with MDS were significantly lower,and the differences were statistically significant (t =2.157,2.349,2.958 ; P ＜ 0.05 or P ＜ 0.01).The helper CD3 + CD4 + T cell (Th) ratio decreased in MDS patients than that of control group (t =2.412,P ＜ 0.05).The inhibition CD3 + CD8 + T cells (Ts) ratio increased (t =2.749,P ＜ 0.01).Th/Ts ratio inversion was seen in MDS patients.As the progression of MDS increase,Ts cell expression gradually increased and NK cells ratio gradually decreased.However,there was no significant difference among three groups.Th cells and B lymphocytes in the risk group were lower than that in the low risk group,and the difference was statistically significant (F =4.896 and 4.516,P ＜0.05),but there was no significant difference in the terms of the number of T lymphocytes,Th cell,ratio of Th/Ts and B lymphocytes among MDS groups.Number of T lymphocytes,B lymphocytes and NK cell count in group A after treatment were increased than that before treatment (t =2.435,2.468,2.653,P ＜ 0.05).In group A,2 cases were complete remission,4 cases with partial remission,and 5 cases with hematologic improvement.The total effective rate was 64.71％ (11/17),and curative effect is obviously better than that of B group (x2 =4.253,P ＜ 0.05).Meanwhile adverse effect was mild.Conclusion The cellular and humoral immune function decreased in MDS patients.The treatment of arsenic trioxide plus thalidomide on MDS is proved safety and efficacy,which might work by improving immune function of MDS patients.