Objective To observe the feasibility and safety of CT-guided fine-needle assisted localization for puncturing difficult lung or liver lesions.Methods Data of 30 patients with single difficult lung or liver lesion,i.e.lesion located at difficult part for puncturing or deep lesion with diameter of 0.5-2.0 cm who underwent CT-guided 22G needle assisted localization before puncturing were retrospectively analyzed.The success rate of fine-needle assisted localization,the success rate of the first-time puncturing and the occurrence of complications were recorded.Results Among 30 difficult lesions,there were 27 lung lesions and 3 hepatic lesions,with a mean diameter of(1.0±0.4)cm.Assisted localization of difficult lesions were successfully performed with 22G needle under CT guidance at the edge of lesion,1 cm adjacent to lesion or at the puncture path,with success rate of fine-needle assisted localization of 100%,and no obvious complication happened.The followed operations included preoperative localization of 14 lung nodules,biopsy of 10 lung nodules and 3 liver nodules,as well as microwave ablation of 3 liver nodules,with the success rate of the first-time puncturing of 100%.Mild pneumothorax was observed in 3 cases(3/27,11.11%)of difficult lung lesions after biopy.No other obvious complication occurred.Conclusion CT-guided fine-needle assisted localization for percutaneous puncturing difficult lung or liver lesions was feasible and safe.

Purpose: The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods: On the basis of the non-Hodgkin’s lymphoma Berlin–Frankfurt–Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results: A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse. Conclusion This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).

Objectives:To investigate the prevalence and related factors of cardiovascular diseases (CVD) and psychological problems in Chinese science and technology workers.Methods:The investigation was organized and conducted by the Innovative and Development Institute of China Association of Senior Scientists and Technologists and Capital Medical University Affiliated Beijing Anzhen Hospital, and included science and technology workers from research institutions and medical institutions in China by random sampling methods through face-to-face and online questionnaire investigation from July 1, 2019 to March 31, 2021. Information including age, sex, work stress status, CVD history, sleep, depression, and anxiety were included in the questionnaire.Results:This survey included 14 552 subjects. Among them, 25.5% were suffered from CVD, 48.6% were with insomnia, 28.8% experienced depression/anxiety (including only depression, only anxiety, depression combined with anxiety), and 15.6% had CVD in combined with depression/anxiety. Taking those without CVD and depression/anxiety as reference group, multiple logistic regression analyses showed that work stress increased the risk of depression/anxiety in subjects without CVD (manageable work stress, OR=2.253, 95 %CI 1.583-3.206, overwhelming work stress OR=7.899, 95 %CI 5.094-12.250), and drinking increased the risk of CVD ( OR=1.978, 95 %CI 1.382-2.833). Moreover, overwhelming work stress ( OR=4.012, 95 %CI 2.515-6.399) and smoking ( OR=2.342, 95 %CI 1.603-3.421) increased the risk of depression/anxiety in subjects with CVD (all P<0.001). Conclusion:The high morbidities of depression/anxiety, CVD, and CVD in combination with depression/anxiety urge us to take actions to protect the heart and mental health of scientific and technological workers.

Objective:To investigate the effects of intraoperative irrigation with hypothermic 3% sodium chloride solution on surgery effect and post-tonsillectomy pain in adults.Methods:A total of 120 adult patients with the plasma tonsillectomy from January to December 2020 in the First Affiliated Hospital of Soochow University were divided into observation group A, observation group B, observation group C and control group according to random number table method, with 30 cases in each group. During operation, observation group A used hypothermia 3% sodium chloride, observation group B used room temperature 3% sodium chloride, observation group C used hypothermia 0.9% sodium chloride, control group used room temperature 0.9% sodium chloride. The quality of surgical field quality, operation time, blood loss in operation, duration of catheter, the postoperative wound pain at 24, 48, 72 h after operation were compared among four groups.Results:The surgical field quality scores were (2.07 ± 0.87) points in the observation group A, significantly lower than in the observation group B (2.57 ± 0.73) points, observation group C (2.60 ± 0.56) points and control group (3.10 ± 0.66) points, the differences were statistically significant ( t=2.71, 2.89, 5.61, all P<0.01). Amounts of blood loss in operation were (9.13 ± 1.74), (10.03 ± 2.81), (10.50 ± 2.09) ml in the observation group A, observation group B and observation group C, significantly lower than in the control group (15.23 ± 3.64) ml, the differences were statistically significant ( t=8.85, 7.54, 6.87, all P<0.01). At 24 h after operation, the scores of Numerical Rating Scale(NRS) were (3.23 ± 0.77), (3.53 ± 0.63), (3.80 ± 0.89) points in the observation group A, observation group B and observation group C, significantly lower than in the control group (4.43 ± 1.17) points. At 48 h after operation, the scores of NRS were (2.37 ± 0.72) points in the observation group A, significantly lower than in the control group (2.93 ± 0.83) points, the differences were statistically significant ( t values were 2.77-5.25, all P<0.01).There was no significant difference in operation time, duration of catheter and wound pain 72 hours after operation among the four groups ( P>0.05). Conclusions:Intraoperative use of hypothermic 3% sodium chloride solution can reduce the amount of blood loss in operation in adult patients with plasma tonsillectomy, increase the clarity of visual field, and effectively reduce postoperative pain.

Retrospective analysis was performed on 1 child with silent inactivation (SI) of asparaginase (ASNas) who was diagnosed with acute lymphoblastic leukemia (ALL) and treated in the First Affiliated Hospital, Sun Yat-Sen University in October 2019.The patient was a 9 years and 3 months old boy who was diagnosed as ALL accompanied with late bone marrow relapse.After pegylated Escherichia coli-Asparaginase (PEG-ASNase) was given, he did not have the expected treatment-related adverse reactions, including hyperammonemia, hypofibrinogenemia, and the low activation of antithrombin Ⅲ (ATⅢ). The plasma asparagine (ASN) concentration failed to meet the depletion criteria and the ASNase activity was 64.5 U/L.Therefore, the SI of ASNase was confirmed.Erwinase was used to replace PEG-ASNase, the lowest level of ATⅢ was 33%, and the lowest level of fibrinogen was 1.20 g/L.Hyperammonemia and decreased ASN were also observed, and the ASNase activity was 1 813.0 U/L.All the above suggested that when, SI occurred, the replacement by Erwinase was effective.The ASNase activity should be monitored in ALL patients who were treated with ASNase.Monitoring the treatment-related adverse reactions such as hyperammonia and coagulation disorders closely has important implications to the SI of ASNase when the detection of ASNase activity was unavailable.

Objective:Endoplasmic reticulum stress(ERS)was used as the research emphasis to further investigate the mechanisms of apoptosis of FLT3-ITD-mutated leukemia cells and decreased expression of FLT3-ITD mutated protein induced by all-trans retinoic acid(ATRA).Methods:FLT3-ITD-mutated leukemia cell lines(MV4-11 and MOLM13)were treated with ATRA. Flow cytometry was conducted to assess cell apoptosis. Real-time fluorescent quantitative PCR(RT-qPCR)and Western blot were used to detect the expression of ERS-related and autophagy-related genes and protein, respectively.Results:A low-dose ATRA further increased FLT3-ITD cells and ERS levels. ATRA acted on the ERS-related PERK/eif2ɑ signaling pathway and continued to increase the ERS of FLT3-ITD cells, resulting in an upregulation of apoptotic gene CHOP expression. After the treatment with ATRA, FLT3-ITD protein in FLT3-ITD cells was decreased. Of the two main ERS-related protein degradation pathways, ER-associated degradation(ERAD)and ER-activated autophagy(ERAA), the expression of ERAD-related protein ATF6 in FLT3-ITD cells was not significantly changed on ATRA, whereas the expression of ERAA-related proteins Atg7 and Atg5 were significantly increased.Conclusions:ATRA further raises the ERS level of FLT3-ITD cells continuously by activating the ERS-related PERK/eif2ɑ signal pathway and induces FLT3-ITD protein autophagy degradation through ERAA pathway, which induces apoptosis of FLT3-ITD-mutated leukemia cells. These results provide preliminary evidence on the use of ATRA in the treatment of refractory leukemia with FLT3-ITD.

[Objective]To explore the effect and the possible mechanism of the proteasome inhibitor MG132 on acute T lympho?blastic leukemia cells.[Methods]The influence of different concentrations of MG132 in the viability and proliferation of CCRF-CEM was measured by MTS. Apoptosis rates of CCRF-CEM treated by MG132 were determined by flow cytometry. After being exposed to MG132,the protein levels of FOXO3a in cytoplasm and nucleus were analyzed by Western blotting. qRT-PCR was applied to detect the mRNA of FOXO3a and Puma in cells treated by MG132. Then CCRF-CEM was stably transfected with antisense FOXO3a using Lentivirus infection. We further investigated the effects of MG132 in FOXO3a-shRNA cells and elucidated the mechanisms of FOXO3a and Puma.[Results]MG132 inhibits the proliferation of CCRF-CEM,but has no cytotoxicity in peripheral blood mononu?clear cells(PBMC). Cellular apoptosis was induced in cells treated with MG132. At mRNA level,MG132 had no influence on FOXO3a,but increased the expression of Puma. However,MG132 promoted the expression of both FOXO3a and Puma at protein level. Interestingly,the expression of FOXO3a increased very little in cytoplasm. In FOXO3a-shRNA cells the expression of FOXO3a and Puma decreased at protein level. FOXO3a's knockdown attenuated the proliferation inhibition mediated by MG132.[Conclusion]MG132 inhibits the proliferation and promotes to apoptosis of CCRF-CEM. One of the mechanism is that MG132 inhib? its the degradation of FOXO3a,and then activates FOXO3a/Puma pathway.

Objective To explore the effect of Flavokawain B on the proliferation and apoptosis of acute T lymphoblastic leukemia(T -ALL)cells and its preliminary mechanism.Methods After the T -ALL cell lines CEM-C7(sensitive to glucocorticoids)and MOLT -4(resistant to glucocorticoids)cells were treated with different concentrations of Flavokawain B,the influence of Flavokawain B on the growth rate and doubling time of CEM-C7 and MOLT -4 cells was observed by 3 -(4,5 -dimethylthiazol -2 -yl)-5 -(3 -carboxymethoxyphenyl)-2 -(4 -sulfophenyl)-2H -tetrazolium(MTS)assay,and apoptosis was analyzed by using flow cytometry.Furthermore,Wes-tern blot assay was used to detect the expressions of Bim,Bcl -2 and cleaved Caspase -9.At last,the expressions of Bim and Bcl -2 in clinical T -ALL patient samples were also detected by using Western blot assay.Results MTS as-say showed that Flavokawain B significantly inhibited the cellular proliferation of T -ALL cell lines in a dose and time dependent manner(P <0.01 ).Flow cytometry findings revealed that Flavokawain B significantly induced the apoptosis of T -ALL cells in a dose -dependent manner(P <0.001 ).Western blot results indicated that Flavokawain B in-creased the expression of Bim and cleaved Caspase -9,and decreased the expression of Bcl -2 in T -ALL cell lines, which increased Bim and decreased Bcl -2 in clinical T -ALL patients samples,both in a dose -dependent manner. Conclusions Flavokawain B can inhibit the proliferation and induce the apoptosis of T -ALL cells by up -regulating the expression of Bim and down -regulating the expression of Bcl -2 and activating Caspase -9,whether resistant to glu-cocorticoids or not.

Objective To screen the peripheral blood circRNA differently expressed in patients with rheumatoid arthritis (RA) and to explore the pathogenetic role of peripheral blood cicRNA in RA by analyzing the data with bioinformatics.Methods The study was performed in 3 RA cases and 3 healthy controls,using circRNA microarrays to screen the circRNA in peripheral blood of patients with RA.The data were normalized and analyzed by R soft package,screening by fold change and P value and searching the differently expressed circRNAs between the two samples by t test.Bioinformatics was performed to analyze the differently expressed circRNAs.Results The results from circRNA microarrays revealed that 36 circRNAs were significantly al-tered in RA patients (P ＜0.05) compared with the control group.Among them,22 were significantly up-regulated,and the other 14 were down-regulated.The GO analysis of the genes involved in the circRNA showed that these genes participated in the progress of biological regulation,cell differentiation,and metabolism.We predicted the target miRNA of all the differently expressed circRNAs,among the results there was a miRNA (hsa-miR-125a-3p) targeted by a circRNA(hsa_circ_0005397) experimentally confirmed by other studies.The relationships among circRNA-miRNA-Gene were predicted by Cytoscape software.Conclusion There are many differently expressed cireRNAs in peripheral blood of patients with RA,and the circRNAs maybe involved in the regulatory mechanisms of Rheumatoid Arthritis.

Gaucher Disease ; diagnosis ; Humans