Objective:To compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.

Objective Nicotinamide phosphoribosyltransferase (Nampt) is a new therapeutic target for ischemic stroke. The aim of this study was to investigate protective effect of liver-derived Nampt on ischemic stroke. Methods Liver-specific Nampt knockout mice were generated using the Cre/loxP system. Nampt^loxP/loxP mice were crossed with liver-specific Cre recombinase expression mice (Alb-Cre), and the progeny genotypes were identified by polymerase chain reaction. Body weight of knockout mice and control mice were measured. Nampt in liver and brain was determined by Western blot assay. Middle cerebral artery occlusion (MCAO), a classical ischemic stroke model, was generated in liver-specific Nampt knockout mice and control mice by electrocoagulation. After 24 h of modeling, neurological deficit scores of each group were evaluated and TTC staining was performed to determine the cerebral infarction volume. The level of plasma Nampt in each group was determined by ELISA. Results Liver-specific Nampt knockout mice with the genotype of Nampt^loxP/loxPAlb-Cre were successfully constructed. The hepatic Nampt expression in knockout mice was significantly decreased by 74.2% compared to control mice, while there was no significant difference in the expression of brain Nampt protein between the knockout group and the control group. Specific knockout of liver Nampt gene expression had no effect on the body weight of mice. Under normal physiological conditions, there was no significant difference in plasma Nampt levels between liver-specific Nampt knockout mice and control mice of the same gender. 24 h after MCAO modeling, there were no significant differences in neurological deficit scores, cerebral infarct volume and plasma Nampt concentration between liver-specific Nampt knockout group and control group. Conclusion Liver-specific Nampt knockout mice are successfully constructed. Liver-derived Nampt has no significant protective effects on ischemic stroke.

Objective:To investigate the effect of altering trigger timing on clinical outcomes of low prognosis patients with gonadotropin-releasing hormone (GnRH) antagonist.Methods:A retrospective cohort study was conducted on 1613 cycles of low prognosis patients based on POSEIDON criteria undergoing in vitro fertilization-embryo transfer (IVF-ET) with GnRH antagonist protocol between January 2017 to June 2019 in Reproductive Medicine Center, Henan Provincial People's Hospital. Patients were divided into 3 groups depending on different trigger timing criteria (conventional trigger group, n=961; advanced trigger group, n=359; delayed trigger group, n=293). Univariate analysis and multivariate logistic regression analysis were used to analyze the effect of trigger timing on clinical outcomes such as cumulative pregnancy rate (CPR) and cumulative live birth rate (CLBR) among different groups. Results:The clinical pregnancy rate of fresh cycle in advanced trigger group, conventional trigger group, delayed trigger group were 35.77% (44/123), 39.16% (150/383), 34.01% (50/147), respectively. CPR and CLBR ranked from low to high in order of advanced trigger group, conventional trigger group and delayed trigger group [CPR: 33.18% (72/217) vs. 42.23% (276/652) vs. 45.27% (91/201), P=0.024; CLBR: 22.97% (48/209) vs. 31.96% (201/629) vs. 35.90% (70/159), P=0.012]. The result of multivariate logistics regression analysis showed that there were no significant differences on clinical pregnancy rate, CPR and CLBR among three groups [delayed trigger group: the clinical pregnancy rate in fresh cycle OR(95% CI)=0.69(0.44-1.09), P=0.114; CPR OR(95% CI)=0.77 (0.51-1.16), P=0.214; CLBR OR(95% CI)=0.83(0.54-1.29), P=0.418; advanced trigger group: the clinical pregnancy rate in fresh cycle OR(95% CI)=0.98(0.60-1.60), P=0.934; CPR OR(95% CI)=0.87(0.58-1.30), P=0.513; CLBR OR(95% CI)=0.86(0.54-1.35), P=0.515]. Conclusion:Conventional trigger could obtain the ideal clinical outcomes in low prognosis patients based on P

Objective:To investigate the effect of endometrial thickness (EMT) on the clinical outcome of hormone replacement frozen-thawed embryo transfer (HRT-FET) cycle in different body mass index (BMI) groups, and to analyze the threshold and optimal EMT and EMT interval corresponding to the ideal clinical pregnancy rate.Methods:A retrospective cohort study was conducted on 10 239 HRT-FET cycles in the Reproductive Medicine Center of Henan Provincial People's Hospital from January 2013 to December 2017, and they were divided into low weight group (BMI<18.5 kg/m 2), normal weight group (BMI=18.5-24.9 kg/m 2), overweight group (BMI=25.0-29.9 kg/m 2) and obese group (BMI≥30.0 kg/m 2). Four subgroups were divided according to EMT, respectively EMT<8.0 mm, 8.0 mm≤EMT<10.0 mm, 10.0 mm≤EMT<12.0 mm, EMT≥12.0 mm. The clinical characteristics and outcome indicators of different EMT subgroups in different BMI groups were compared. To achieve the ideal clinical pregnancy rate, multiple regression analysis, curve fitting and threshold effect analysis were used to find the best EMT and thickness interval. Results:1) After adjusting for confounding factors, multiple regression analysis showed that, there were no significant differences in clinical pregnancy rate and live birth rate among subgroups with the increase of EMT (all groups P>0.05). The clinical pregnancy rate and the live birth rate increased with the increase of EMT between subgroups of normal body weight group and super-recombinant subgroups (all P<0.001 for normal body weight subgroups, P=0.123, P=0.009, P=0.016 and all P<0.001 for super-recombinant subgroups). In the obesity group, with the increase of EMT, the clinical pregnancy rate did not increase significantly except EMT≥12.0 mm subgroup ( P=0.449, P=0.279, P=0.021), while the live birth rate increased significantly ( P=0.014, P=0.005, P<0.001). 2) Curve fitting showed that in the population of low weight and obese, influence of EMT on clinical pregnancy rate was a straight line, in the population of normal weight and overweight, influence of EMT on clinical pregnancy rate was a curve, as EMT increased the clinical pregnancy rate raised and then decreased, the impact on the live birth rate appeared similar. 3) According to the curve fitting, the threshold effect analysis of the normal weight group showed that the endometrial inflection point of EMT on the clinical pregnancy rate and the live birth rate was 10.0 mm. When EMT was lower than 10.0 mm, the clinical pregnancy rate and the live birth rate increased by 20% and 19% for every 1.0 mm increase in endometrial thickness ( OR=1.20, 95% CI=1.13-1.26; OR=1.13,95% CI=1.13-1.26). In overweight group, the inflection point of EMT on the clinical pregnancy rate and the live birth rate was also 10.0 mm. When EMT was lower than 10.0 mm, the clinical pregnancy rate and the live birth rate increased by 24% and 26% for every 1.0 mm increase in EMT ( OR=1.24, 95% CI=1.13-1.26; OR=1.26, 95% CI=1.14-1.40). When EMT exceeded 10.0 mm, the clinical pregnancy rate and the live birth rate did not increase significantly with the increase of EMT. Conclusion:In HRT-FET cycle, the endometrial thickness has an effect on the clinical pregnancy rate and the live birth rate in the normal weight group and the overweight group. The clinical pregnancy rate and the live birth rate were the best when the EMT was between 10.0-13.5/10.0-12.7 mm and 10.0-14.0/10.0-12.5 mm, respectively. Whether the endometrium was too thin or too thick would affect the clinical pregnancy outcome. The influence of EMT on clinical pregnancy rate and live birth rate was linear between the low weight group and the obese group, but further study is needed.

Objective:To investigate the effect of altering trigger timing on clinical outcomes of low prognosis patients with gonadotropin-releasing hormone (GnRH) antagonist.Methods:A retrospective cohort study was conducted on 1613 cycles of low prognosis patients based on POSEIDON criteria undergoing in vitro fertilization-embryo transfer (IVF-ET) with GnRH antagonist protocol between January 2017 to June 2019 in Reproductive Medicine Center, Henan Provincial People's Hospital. Patients were divided into 3 groups depending on different trigger timing criteria (conventional trigger group, n=961; advanced trigger group, n=359; delayed trigger group, n=293). Univariate analysis and multivariate logistic regression analysis were used to analyze the effect of trigger timing on clinical outcomes such as cumulative pregnancy rate (CPR) and cumulative live birth rate (CLBR) among different groups. Results:The clinical pregnancy rate of fresh cycle in advanced trigger group, conventional trigger group, delayed trigger group were 35.77% (44/123), 39.16% (150/383), 34.01% (50/147), respectively. CPR and CLBR ranked from low to high in order of advanced trigger group, conventional trigger group and delayed trigger group [CPR: 33.18% (72/217) vs. 42.23% (276/652) vs. 45.27% (91/201), P=0.024; CLBR: 22.97% (48/209) vs. 31.96% (201/629) vs. 35.90% (70/159), P=0.012]. The result of multivariate logistics regression analysis showed that there were no significant differences on clinical pregnancy rate, CPR and CLBR among three groups [delayed trigger group: the clinical pregnancy rate in fresh cycle OR(95% CI)=0.69(0.44-1.09), P=0.114; CPR OR(95% CI)=0.77 (0.51-1.16), P=0.214; CLBR OR(95% CI)=0.83(0.54-1.29), P=0.418; advanced trigger group: the clinical pregnancy rate in fresh cycle OR(95% CI)=0.98(0.60-1.60), P=0.934; CPR OR(95% CI)=0.87(0.58-1.30), P=0.513; CLBR OR(95% CI)=0.86(0.54-1.35), P=0.515]. Conclusion:Conventional trigger could obtain the ideal clinical outcomes in low prognosis patients based on P

Objective:To investigate the effect of endometrial thickness (EMT) on the clinical outcome of hormone replacement frozen-thawed embryo transfer (HRT-FET) cycle in different body mass index (BMI) groups, and to analyze the threshold and optimal EMT and EMT interval corresponding to the ideal clinical pregnancy rate.Methods:A retrospective cohort study was conducted on 10 239 HRT-FET cycles in the Reproductive Medicine Center of Henan Provincial People's Hospital from January 2013 to December 2017, and they were divided into low weight group (BMI<18.5 kg/m 2), normal weight group (BMI=18.5-24.9 kg/m 2), overweight group (BMI=25.0-29.9 kg/m 2) and obese group (BMI≥30.0 kg/m 2). Four subgroups were divided according to EMT, respectively EMT<8.0 mm, 8.0 mm≤EMT<10.0 mm, 10.0 mm≤EMT<12.0 mm, EMT≥12.0 mm. The clinical characteristics and outcome indicators of different EMT subgroups in different BMI groups were compared. To achieve the ideal clinical pregnancy rate, multiple regression analysis, curve fitting and threshold effect analysis were used to find the best EMT and thickness interval. Results:1) After adjusting for confounding factors, multiple regression analysis showed that, there were no significant differences in clinical pregnancy rate and live birth rate among subgroups with the increase of EMT (all groups P>0.05). The clinical pregnancy rate and the live birth rate increased with the increase of EMT between subgroups of normal body weight group and super-recombinant subgroups (all P<0.001 for normal body weight subgroups, P=0.123, P=0.009, P=0.016 and all P<0.001 for super-recombinant subgroups). In the obesity group, with the increase of EMT, the clinical pregnancy rate did not increase significantly except EMT≥12.0 mm subgroup ( P=0.449, P=0.279, P=0.021), while the live birth rate increased significantly ( P=0.014, P=0.005, P<0.001). 2) Curve fitting showed that in the population of low weight and obese, influence of EMT on clinical pregnancy rate was a straight line, in the population of normal weight and overweight, influence of EMT on clinical pregnancy rate was a curve, as EMT increased the clinical pregnancy rate raised and then decreased, the impact on the live birth rate appeared similar. 3) According to the curve fitting, the threshold effect analysis of the normal weight group showed that the endometrial inflection point of EMT on the clinical pregnancy rate and the live birth rate was 10.0 mm. When EMT was lower than 10.0 mm, the clinical pregnancy rate and the live birth rate increased by 20% and 19% for every 1.0 mm increase in endometrial thickness ( OR=1.20, 95% CI=1.13-1.26; OR=1.13,95% CI=1.13-1.26). In overweight group, the inflection point of EMT on the clinical pregnancy rate and the live birth rate was also 10.0 mm. When EMT was lower than 10.0 mm, the clinical pregnancy rate and the live birth rate increased by 24% and 26% for every 1.0 mm increase in EMT ( OR=1.24, 95% CI=1.13-1.26; OR=1.26, 95% CI=1.14-1.40). When EMT exceeded 10.0 mm, the clinical pregnancy rate and the live birth rate did not increase significantly with the increase of EMT. Conclusion:In HRT-FET cycle, the endometrial thickness has an effect on the clinical pregnancy rate and the live birth rate in the normal weight group and the overweight group. The clinical pregnancy rate and the live birth rate were the best when the EMT was between 10.0-13.5/10.0-12.7 mm and 10.0-14.0/10.0-12.5 mm, respectively. Whether the endometrium was too thin or too thick would affect the clinical pregnancy outcome. The influence of EMT on clinical pregnancy rate and live birth rate was linear between the low weight group and the obese group, but further study is needed.

Objective:A multi-center and large sample volume study was conducted on the verification and improvement of the early established criteria for intelligent routine urinalysis validation (including the microscopic review rules and manual validation rules, referred to as intelligent criteria for short), in order to improve the clinical application of this intelligent criteria.Methods:A total of 31 456 urine specimens were collected from the inpatients and outpatients in six hospitals in China, from March to September 2019. Firstly, 3105 specimens were analyzed for preliminary verification and improvement of the intelligent criteria based on the results of the microscopic examination and manual validation. Secondly, 28 351 specimens were used to verify the clinical application of the improved intelligent criteria. All samples were manually validated as reference.Results:The approval inconsistency rate of the manual validation rules in the original intelligent criteria was 8.59% (202/2 352), and the interception inconsistency rate was 8.84% (208/2 352). The false negative rate and the microscopic review rate of the microscopic review rules were similar to the previous results. Based on an in-depth analysis of big data and the discussions by senior technicians from eight hospitals, one microscopic review rules and four manual validation rules were added, meanwhile two manual validation rule was deleted. The manual validation standards were unified. Finally, the intelligent criteria was improved. Based on the improved intelligent criteria, for microscopic review rules, the false positive rate, false negative rate (misdiagnosis rate), and microscopic review rate did not change significantly, which were 14.72% (457/3 105), 4.06% (126/3 105), and 24.73% (768/3 105), respectively. The approval inconsistency rate and the interception inconsistency rate of manual validation rules were both reduced to 0; the total manual validation rate of the intelligent criteria was 50.89% (1 580/3 105), and the auto-validation rate was 49.11% (1 525/3 105). The large sample volume verification results were consistent with the preliminary verification results of the improved intelligent criteria.Conclusion:This multi-center and large sample volume study had shown that the improved intelligent criteria had better clinical performance.

Objective:To investigate the risk factors of fulminant myocarditis in children.Methods:The clinical data of 67 children with clinical diagnosis of viral myocarditis from January 2015 to December 2018 in our hospital were retrospectively analyzed.The children were divided into fulminant myocarditis group( n=13)and common myocarditis group( n=54). The clinical data of gender, age, history of pre-infection, clinical manifestations, laboratory tests, electrocardiogram, echocardiography, and imaging findings were compared between the two groups.The multiple Logistic regression analysis was used to identify the independent risk factors of fulminant myocarditis. Results:(1)Seven cases(53.8%)died in the fulminant myocarditis group, 4 cases(30.8%) of them died within 24 hours after admission, and all the children in the common myocarditis group improved and discharged.(2)The incidences of facial cyanosis, abdominal distension, convulsions, and chills were higher in the fulminant myocarditis group than those in the common myocarditis group( P<0.05). (3)The level of creatinekinase-MB, lactate dehydrogenase, α-hydroxybutyric dehydrogenase and aspartate transferase in the fulminant myocarditis group were higher than those in the common myocarditis group( P<0.05). (4)On electrocardiogram, QRS wave duration in the fulminant myocarditis group was longer than that in the common myocarditis group[118(82, 127)ms vs.62(62, 122)ms, P<0.05]. The incidences of ventricular tachycardia in the fulminant myocarditis group was higher than that in the common myocarditis group( P<0.05). (5)In the fulminant myocarditis group, the incidences of left ventricular ejection fraction(LVEF)decreased, the left ventricular short axis fraction shortening(LVFS), and the incidence of left ventricular enlargement were higher than those in the common myocarditis group[92.3%(12/13)vs.18.5%(10/54), 84.6%(11/13)vs.9.3%(5/54), 76.9%(10/13)vs.13.0%(7/54), P<0.05]. Chest X-ray examination of the fulminant myocarditis group showed that the incidences of heart shadow enlargement and pulmonary blood stasis were higher than those in the common myocarditis group( P<0.05). (6)Multiple Logistic regression analysis revealed that LVEF reduction( OR=19.015, 95% CI 1.456-248.348, P=0.025), LVFS reduction( OR=18.691, 95% CI 2.062-169.453, P=0.009)and prolonged QRS wave duration( OR=1.040, 95% CI 1.001-1.082, P=0.046) were independent risk factors for fulminant myocarditis. Conclusion:The early mortality of fulminant myocarditis is high in children, and the LVEF reduction, LVFS reduction and prolonged QRS wave duration are independent risk factors for fulminant myocarditis.

Objective To explore the effects of all-trans-retinoic acid (ATRA) on the proliferation of human lung adenocarcinoma cell line A549 and the expression of APLNR (apelin receptor) gene.Methods The inhibition of proliferation of human lung adenocarcinoma cell lines A549 cultured in vitro with or without ATRA was measured by MTT (methyl thiazolyl tetrazolium,MTT) method.The morphological changes in the cells were observed by light microscopy.The cell cycle and apoptosis were analyzed by flow cytometry.The levels of APLNR,cyclin D1 and p16 proteins were detected by western blot.Results After treatment of ATRA,the proliferation of A549 cells was obviously inhibited in dose-and time-independent manner (P ＜ 0.01).The cell morphology was significantly changed.The cycle of A549 cells was blocked at G0/G1 phase and the apoptosis rate was increased.With the increasing concentration of ATRA,the expressions of cyclin D1 and APLNR were down-regulated but the expression of p16 was up-regulated (P ＜ 0.01).Conclusion ATRA could inhibit the proliferation of A549 cells by retardant cell cycle of A549 cells at G0/G1 phase and inducing the apoptosis,and down-regulate the expression of APLNR gene.

Objective:To evaluate the efficacy and safety of sequential platinum regimen in young patients with diffuse large B-cell lym-phoma (DLBCL). Methods:Newly diagnosed young patients with DLBCL, who were hospitalized from January 2005 to June 2012 in the Affiliated Cancer Hospital of Zhengzhou University, were selected according to the requirements. The patients were divided into stan-dard and sequential platinum regimen groups. The remission rates were compared usingχ2 test, whereas the five-year survival rates between the two groups were compared using the Kaplan–Meier method. Multivariate survival analysis was performed using the Cox proportional regression. Subgroup analysis was conducted to select candidate patients for the sequential platinum regimen. Results:A total of 331 patients were enrolled in the study, in which 129 were provided with sequential platinum regimen and 202 were provided with the standard regimen. Sequential regimen yielded higher rates of complete remission (80%vs. 63%, P=0.001), five-year progres-sion-free survival (PFS;60%vs. 50%, P=0.014), and overall survival (OS;70%vs. 58%, P=0.016) than the standard regimen. Multivariate analysis revealed that sequential regimen was an independent prognostic factor for PFS (hazard ratio HR=0.635, P=0.012) and OS (HR=0.625, P=0.021). Subgroup analysis showed that patients with good prognosis and patients who did not receive rituximab benefited more from the sequential platinum regimen. Sequential platinum regimen did not increase the occurrence of adverse effects com-pared with the standard regimen. Conclusion:Sequential platinum regimen is a safe treatment that can improve the survival of young patients with DLBCL. Patients with good prognosis and patients who did not receive rituximab can benefit more from the treatment with sequential platinum regimen.