Objective:To explore the relapse-related genes and their clinicopathological connections of diffuse large B cell lymphoma (DLBCL).Methods:Targeted panel sequencing was conducted on 32 eligible DLBCL samples; the patients were diagnosed, treated, and went into complete remission at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, including 14 cases with recurrence (relapsed group) and 18 cases with long-term complete remission of over five years (remission group). Clinical and pathological data were further reviewed. Fisher′s exact test was employed to compare the differences in clinicopathological characteristics and mutation patterns between the two groups.Results:Among the 32 patients, there were 18 males and 14 females, with a male to female ratio of 1.3∶1.0 and a median age of 53 (45.5, 67.0) years. In the relapsed group, PIM1 (11/14), KMT2D (7/14), PRDM1 (6/14), MYD88 (6/14), DTX1 (6/14) emerged as the most frequently mutated genes. In the remission group, while recurrent PIM1, KMT2D and MYD88 mutations were also observed, the TP53 gene exhibited the highest mutation frequency (6/18). Compared to the remission group, relapsed group showed elevated mutation frequencies of PIM1 ( P=0.013) and FAT4 ( P=0.010), alongside a reduced incidence of TP53 mutations. In all 32 patients, DLBCL with CD79B, CCND3, DTX1, KMT2D and PRDM1 mutations demonstrated a propensity towards advanced clinicopathologic stage. Conclusions:Relapsed DLBCL has distinctive clinicopathological and genetic features. PIM1 and FAT4 may be served as potential biomarkers for screening relapsed DLBCL-NOS and as targets for novel therapeutic strategies.

Objective:To explore the relapse-related genes and their clinicopathological connections of diffuse large B cell lymphoma (DLBCL).Methods:Targeted panel sequencing was conducted on 32 eligible DLBCL samples; the patients were diagnosed, treated, and went into complete remission at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, including 14 cases with recurrence (relapsed group) and 18 cases with long-term complete remission of over five years (remission group). Clinical and pathological data were further reviewed. Fisher′s exact test was employed to compare the differences in clinicopathological characteristics and mutation patterns between the two groups.Results:Among the 32 patients, there were 18 males and 14 females, with a male to female ratio of 1.3∶1.0 and a median age of 53 (45.5, 67.0) years. In the relapsed group, PIM1 (11/14), KMT2D (7/14), PRDM1 (6/14), MYD88 (6/14), DTX1 (6/14) emerged as the most frequently mutated genes. In the remission group, while recurrent PIM1, KMT2D and MYD88 mutations were also observed, the TP53 gene exhibited the highest mutation frequency (6/18). Compared to the remission group, relapsed group showed elevated mutation frequencies of PIM1 ( P=0.013) and FAT4 ( P=0.010), alongside a reduced incidence of TP53 mutations. In all 32 patients, DLBCL with CD79B, CCND3, DTX1, KMT2D and PRDM1 mutations demonstrated a propensity towards advanced clinicopathologic stage. Conclusions:Relapsed DLBCL has distinctive clinicopathological and genetic features. PIM1 and FAT4 may be served as potential biomarkers for screening relapsed DLBCL-NOS and as targets for novel therapeutic strategies.

Objective:To investigate the influential factors of internal fixation for closed posterior ankle fractures.Methods:The clinical data of 352 patients with closed ankle fractures who received treatment in Yeda Hospital from January 2016 to June 2020 were retrospectively analyzed. Among the 352 patients, 232 patients had posterior ankle fractures. These patients were grouped according to whether they had undergone internal fixation. The factors that affect internal fixation for closed posterior ankle fractures were analyzed by univariate and multivariate analyses.Results:232 patients out of 352 patients with closed ankle fractures had closed posterior ankle fractures, accounting for 65.91%. A total of 102 (43.97%) patients with posterior ankle fractures underwent internal fixation. There were significant differences in Bartonicek classification, the proportion of the posterior subluxation of the talus, the proportion of posterior ankle bone area, the proportion of posterior ankle bone area ≥ 25% displayed on X-ray image, the proportion of posterior ankle bone area ≥ 15% displayed on CT scan, the proportion of outward displacement of bone mass (92.31% vs. 41.82%) and the proportion of die-punch bone mass (94.23% vs. 40.00%) between patients receiving and not receiving internal fixation ( χ2 = 3.89, 0.26, 1.51, 0.31, 9.27, 8.67, 1.68, 5.84, 10.33, 12.47, 11.48, 10.69, 1.39, all P < 0.05). Multivariate analysis of a logistic regression model showed that posterior subluxation of the talus and the proportion of posterior ankle bone area ≥ 15% displayed on CT scan were independent influential factors of internal fixation for closed posterior ankle fracture ( OR = 5.47, 9.29, 95% CI:1.62-9.75, 3.24-27.01, all P < 0.05). Conclusion:In patients with closed ankle fractures, posterior ankle fractures and internal fixation are more common. At the same time, the posterior subluxation of the talus and the proportion of posterior ankle bone area ≥ 15% displayed on CT scan are closely related to receiving internal fixation.

Objective To explore the clinical characteristics and correlation of adult primary nephrotic syndrome (PNS) with thyroid dysfunction,and early identify high-risk adult PNS patients with abnormal thyroid function by clinical data.Methods The clinical data of 101 adult PNS patients in Heji Hospital Affiliated to Changzhi Medical College from March 2015 to December 2017 were retrospectively analyzed.According to the thyroid function,the patients were divided into 2 groups:normal thyroid function group (67 cases) and thyroid dysfunction group (34 cases),including 9 cases with low triiodothyronine (T3) syndrome and 25 cases with subclinical hypothyroidism.The clinical data were compared,and the correlation between thyroid-stimulating hormone (TSH) and 24 h urinary protein,blood albumin and systolic blood pressure were analyzed.Results The incidence of thyroid dysfunction in adult PNS patients was 33.66％ (34/101),including 21 cases of membranous nephropathy,8 cases of minimal change disease,4 cases of IgA nephropathy and 1 case of membranoproliferative nephritis.The 24 h urinary protein in thyroid dysfunction group was significantly higher than that in normal thyroid function group:(8.76 ± 3.62) g vs.(6.96 ± 3.43) g,the albumin was significantly lower than that in normal thyroid function group:(21.82 ± 4.89) g/L vs.(24.49 ± 4.14) g/L,and there were statistical differences (P＜0.05 or ＜0.01);there was no significant difference in gender composition,age,course of disease,systolic blood pressure,diastolic blood pressure,body mass index,hemoglobin,platelet,creatinine,cystatin C,fasting blood glucose,total cholesterol,triacylglycerol,low-density lipoprotein cholesterol (LDL-C),fibrinogen,complement C3,IgG,IgM,IgA,PNS types and comorbidities between 2 groups (P＞0.05).The results of subgroup analysis results showed that the systolic blood pressure in subclinical hypothyroidism patients of thyroid dysfunction group was significantly higher than that in normal thyroid function group and the low T3 syndrome patients of thyroid dysfunction group:(148.16 ± 18.09) mmHg (1 mmHg =0.133 kPa) vs.(139.55 ± 18.77) and (127.78 ± 16.81) mmHg,the 24 h urinary protein was significantly higher than that in normal thyroid function group:(9.00 ± 3.64) g vs.(6.96 ± 3.43) g,the albumin was significantly lower than that in normal thyroid function group:(21.71 ± 5.26) g/L vs.(24.49 ± 4.14) g/L,and there were statistical differences (P＜0.05).Pearson correlation analysis result showed that TSH had no correlation with 24 h urinary protein and systolic blood pressure (r =0.193 and 0.072,P =0.053 and 0.472);however TSH was negatively correlated with albumin (r =-0.340,P =0.001).Conelusions In adult PNS patients with thyroid dysfunction,membranous nephropathy is the most common,followed by minimal change disease.The systolic blood pressure in PNS patients with subclinical hypothyroidism is significantly higher than that in patients with normal thyroid function and low T3 syndrome.In adult PNS patients,the lower the blood albumin is,the more likely they have thyroid dysfunction.

Objective To reduce the incidence of muscle spasm during hemodialysis by using the management method of the quality control circle (QCC).Methods QCC team was founded to determine the theme and plan events. Brainstorming was used to develop countermeasures. Countermeasures implementation was divided into four stages and verification conducted, so as to ensure clear countermeasure effectiveness. The patients confirmed the effect and the team members performed self-evaluation.Results After QCC management mode, muscle cramps patient during dialysis incidence dropped to 2.3%, decreased significantly compared with that before implementing countermeasures (P＜0.05). After the implementation of quality control circle, circle members self-evaluation 8 content, in which seven scores were higher than the previous implementation with a statistically significant difference (P＜0.05).Conclusions The quality control circle pattern can significantly reduce the incidence of muscle spasms, improve the professional level as well as the ability to work in all the medical staff, and bring a new operating mode for future health care work.

Objective:Colorectal cancer is one of the common gastrointestinal tumors.Recent studies have shown that, the expression of PDEF can promote the differentiation of Secretory progenitor cells to goblet cells in the intestinal tissue.Therefore the oc-currence of colorectal cancer may be related to expression of PDEF.In this study,we tried to investigate the effects of proliferation and invasion after interference targeting prostate-derived ETS factor in colorectal cell lines HT29.Methods: HT29 cells were transiently transfected with PDEF shRNA plasmids and blank control plasmid via cathodolyte liposome transfection method.By fluorescence microscopy,RT-PCR,Western blot technique to detect the expression of PDEF mRNA and protein in normal control group,blank control group,shRNA group.The proliferation and invasion ability of HT29 cells after transfection were assessed by MTT assay and Transwell invasion assay respectively.Results: Green fluorescent protein was observed in blank control plasmid group and shRNA plasmid group.Western blot showed the reduced PDEF protein expression compared with normal control group and blank control group.Interference PDEF gene expression can significantly promote the proliferation of HT29 cells (P<0.05).The ability of cell invasion in interference group was significantly higher than the normal control group and blank control group after 48h ( P<0.05).Conclusion:Interference PDEF in HT29 cells can promote cell proliferation and invasion.