Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective:To investigate the efficacy and safety of fat suction combined with bipolar radiofrequency on face and neck rejuvenation.Methods:A total of 115 patients with face and neck fat deposits and skin laxity underwent fat suction combined with bipolar radiofrequency between December 2021 and October 2022 by the same surgeon in Changsha My Like Medical Cosmetology Hospital. There were 3 men and 112 women in this research. The mean age was 36.1 years (range, 26-55 years) and the mean body mass index was 21.4 (range, 16.8-27.7 kg/cm 2). Postoperative patient satisfaction surveys were conducted and 2 independent doctors evaluated clinical effect with preoperative and postoperative photographs at 3-6 months postoperatively. Results:The mean amount of fat aspirated was 44.5 ml (range, 10-92 ml) and the mean energy delivered was 4.5 kJ (range, 2.1-8.9 ml). 88.7% of patients were satisfied with their postoperative effect (102/115 patients). 92.2% of doctors were satisfied with the postoperative effect (106/115 patients). Four out of 115 patients (3.5%) developed irregularity by fat suction.Conclusions:Fat suction combined with bipolar radiofrequency can effectively reduce the fat accumulation of facial and neck and significantly improve skin relaxation. It is an effective method to rejuvenate facial and neck.

Closed-loop hospital management can effectivly cope with the COVID-19 pandemic. In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks, Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites, materials and personnel shifts in advance, and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services, in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022, 317 of 1 459 hemodialysis patients in the alliance were diverted to other centers for treatment, accumulating 1 215 times/cases of treatments without obvious adverse reactions. The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.

Obj ective To observe the detection rate of pathogens in hospitalized children with acute respiratory infection (ARI)from the year 2011 to 2013 in Changzhou region.Methods Hospitalized children with ARI (a total of 6 366 cases)in Changzhou First People′s Hospital from January 2011 to December 2013 were enrolled.Clinical materials of children were collected.Serum legionella pneumophila,mycoplasma pneumoniae,Q fever rickettsia,chlamydia pneumoniae,aden-ovirus,respiratory syncytial virus,influenza A virus,influenza B virus,para-influenza virus types 1/2 and IgM-3 antibody were detected by using indirect immuno-fluorescence assay (IFA).The detection of pathogens was analyzed,and detection rate of each pathogen in children with different ages,seasonal distribution and causative condition of each pathogen were analyzed as well.Results At least one kind of pathogen was detected positively in 1 ,850 cases with the total detection rate of 29.06% (1850/6366 ).Mycoplasma pneumoniae was the most common pathogen with the detection rate of 2 5 .3%(1 4 2 3 /6 3 6 6 ).The median age of children infected by respiratory syncytial virus and adenovirus was less than the median age of overall children (P<0 .0 1 ).The respiratory syncytial virus was detected highest in the group with the age of 1 to 6 months (3.58%,14/391);mycoplasma pneumoniae was detected the most in the rest groups with other ages.In addition to Q fever pathogen rickettsia,chlamydia pneumoniae,the rest of the pathogens were significantly seasonal.Mycoplasma pneumoniae infections were the most common in acute respiratory infection,laryngitis,bronchitis,bronchiolitis,bronchial pneumonia and bronchial asthma with infection.Conclusion Respiratory syncytial virus is the common cause of respirato-ry tract infection in hospitalized children with ARI in Changzhou.Different pathogens have dif-ferent age distributions with distinguished seasonal and disease distribution characteristics.

Obj ective To observe the detection rate of pathogens in hospitalized children with acute respiratory infection (ARI)from the year 2011 to 2013 in Changzhou region.Methods Hospitalized children with ARI (a total of 6 366 cases)in Changzhou First People′s Hospital from January 2011 to December 2013 were enrolled.Clinical materials of children were collected.Serum legionella pneumophila,mycoplasma pneumoniae,Q fever rickettsia,chlamydia pneumoniae,aden-ovirus,respiratory syncytial virus,influenza A virus,influenza B virus,para-influenza virus types 1/2 and IgM-3 antibody were detected by using indirect immuno-fluorescence assay (IFA).The detection of pathogens was analyzed,and detection rate of each pathogen in children with different ages,seasonal distribution and causative condition of each pathogen were analyzed as well.Results At least one kind of pathogen was detected positively in 1 ,850 cases with the total detection rate of 29.06% (1850/6366 ).Mycoplasma pneumoniae was the most common pathogen with the detection rate of 2 5 .3%(1 4 2 3 /6 3 6 6 ).The median age of children infected by respiratory syncytial virus and adenovirus was less than the median age of overall children (P<0 .0 1 ).The respiratory syncytial virus was detected highest in the group with the age of 1 to 6 months (3.58%,14/391);mycoplasma pneumoniae was detected the most in the rest groups with other ages.In addition to Q fever pathogen rickettsia,chlamydia pneumoniae,the rest of the pathogens were significantly seasonal.Mycoplasma pneumoniae infections were the most common in acute respiratory infection,laryngitis,bronchitis,bronchiolitis,bronchial pneumonia and bronchial asthma with infection.Conclusion Respiratory syncytial virus is the common cause of respirato-ry tract infection in hospitalized children with ARI in Changzhou.Different pathogens have dif-ferent age distributions with distinguished seasonal and disease distribution characteristics.

Objective To investigate the effects of a proliferation-inducing ligand(APRIL)gene silencing by small interfering RNA(siRNA)on cell cycle and proliferation of colon carcinoma SW480 cells.Methods The siRNA plasmid vector targeting APRIL gene,named as siRNA-APRIL,was transfected into SW480 cells,transfected with scrambled vector as a nontargeting control and nontransfected group as another control.APRIL mRNA and protein expression were examined by real-time PCR and Western blot,respectively.Cell proliferation activity was analyzed by cell counting kit-8(CK-8),cell cycle was detected by flow cytometry,and p21 together with p27,two important regulatory genes in cell cycle,were measured by RTPCR.Results Compared with nontargeting control and nontransfected control,APRIL expression was inhibited significantly at both mRNA and protein level by siRNA-APRIL being transfected in SW480 cells(P ＜0.05).Cell proliferation ability was drastically repressed after siRNA-APRIL being transfected at 48 h,72 h and 96 h(P ＜ 0.05).After transfected 48 h,the percent of Go/G1 phase cell was significantly increased,S and G2/M phase cell were significantly decreased,the number of cell in apoptosis was increased and the expression of p21 and p27 mRNA were up-regulated(P ＜ 0.05).There was no significant difference when compared the two control groups each other(P ＞ 0.05).Conclusion siRNA-APRIL can effectively knockdown the expression of APRIL gene in SW480 cells,moreover,it can inhibit the cell proliferation and induce G0/G1 phase cell cycle arrest,which occurrence may involve in upregulation the mRNA expression of p21 and p27.

Finite element analysis can analyze the stress and strain change of object with complex shape,structure,constitution and load condition,and is widely applied to spinal biomechanical studies due to its controllability,reproducibility and versatility in mechanics tests.The article briefly introduced several finite element analysis software,summarized the mechanical characteristics of vertebral body,intervertebral disc,accessories and the ligament and muscle around the spine,and summarized research achievements of finite element analysis in lumbar fusion,concerning the biomechanics of Cage,its influence on lumbar fusion and related surgery choice,dynamic fusion,artificial intervertebral disc and the biomechanical variation of different fusion style after spinal tumor vertebrectomy.Finite element analysis can help understand the spine biomechanics and provide biomechanical reference for lumbar fusion choice.

Objective To evaluate the effect of revascularization of the renal artery on urinary microglobulin in patients with coronaryartery disease and significant renal artery stenosis (RAS). Methods Forty-four patients with coronary artery disease and severe RAS (luminal narrowing＞70%) underwent percutaneous transluminal renal artery angioplasty (PTRA) and stenting, as well as percutaneous coronary intervention. The urine -microglobulin (α1-MG) and β2-Cmicroglobulin (β2-MG) at baseline and at 3 months after the procedures were measured. Procedural success rate, procedural complications, serum creatinine concentration at baseline and at 3-months were also recorded. Results At 3-months after the renal revascularization therapy, there was no significant change of urine α1-MG ompared with that of the baseline, however, the urine β2-MG decreased significantly 3-months after the treatment (237±187μg/L vs 377±173 μg/L, P＜0.01). Multivariate analysis revealed that persistent elevation of urine was an independent predictor of severe events (including re-admission and renal failure) after renal revascularization therapy in patients with severe RAS (OR=3.01,95% CI 1.01-8.95, P=0.036). Conclusions In patients with coronary artery disease and severe RAS, revascularization with PTRA and stenting may improve renal tubular function, but a continuous high level of urinary microglobulins after intervention is associated with more frequent re-hospitalization and renal failure.

0.05) were of no significance between the 2 group. There was no difference in recurrent agina and improvement of blood pressure. But rates of re-admission (26.9% vs 7.3%) and comorbity of renal failure (23.1% vs 1.8%) in group Ⅰ were significantly higher than those in group Ⅱ ( P