1.Expression Level of Small Nuclear Ribonucleoprotein D1 in Gastric Cancer and Its Effect on Prognosis.
Li-Xia YIN ; Jing-Jing YANG ; Min-Zhu NIU ; Zhi-Jun GENG ; Li JIANG-YAN ; Li JING
Acta Academiae Medicinae Sinicae 2025;47(1):1-9
Objective To investigate the expression of small nuclear ribonucleoprotein D1 (SNRPD1) in the gastric cancer tissue and evaluate the predictive value of SNRPD1 expression level for the long-term prognosis of gastric cancer patients and the possible functioning mechanism of SNRPD1. Methods The UALCAN and Gene Expression Profiling Interactive Analysis (GEPIA) were employed to analyze the expression level of SNRPD1 in pan-cancer and its relationship with the prognosis of gastric cancer.The clinical data of 109 patients who underwent radical surgery for gastric cancer from January 2014 to January 2017 in the First Affiliated Hospital of Bengbu Medical University were retrospectively analyzed.Gastric cancer and paracancerous tissue samples were collected,and the expression of SNRPD1 was detected by immunohistochemical staining.Lentiviral transfection was employed to construct the BGC-823 gastric cancer cell models with stable high and low expression of SNRPD1,respectively.The CCK-8 assay and colony formation assay were employed to measure the proliferation of gastric cancer cells,and flow cytometry was used to analyze the cell cycle.Western blotting was employed to determine the expression levels of proteins in the signaling pathway. Results The data from UALCAN and GEPIA showed that SNRPD1 was highly expressed in the tissue of malignant tumors including gastric cancer (P<0.001).The expression level of SNRPD1 in the gastric cancer tissue was higher than that in the paracancerous tissue (P<0.001).Moreover,the expression level of SNRPD1 was positively correlated with the levels of carcinoembryonic antigen (P<0.001),carbohydrate antigen 19-9 (P<0.001),G stage (P=0.042),T stage (P=0.002),and N stage (P=0.027) in the patients with gastric cancer.The high expression of SNRPD1 had a predictive value for the long-term prognosis of gastric cancer (P<0.001),and it was an independent risk factor for the death of gastric cancer patients (P=0.003).The results of gene ontology and kyoto encyclopedia of genes and Genomes enrichment analyses showed that SNRPD1 was involved in the regulation of the cell cycle.The results of CCK-8 and colony formation assays showed that up-regulation of SNRPD1 promoted the proliferation of gastric cancer cells (P<0.001,P<0.001).The up-regulation of SNRPD1 up-regulated the expression of cyclin-dependent kinase 6 and G1/S-specific cyclin-D1 (P<0.001,P=0.002),whereas the interference in SNRPD1 led to opposite results (P=0.004,P<0.001).SNRPD1 accelerated the G1/S phase transition of gastric cancer cells (P<0.001).The overexpression of SNRPD1 promoted the expression of phosphorylated phosphatidylinositol 3-kinase (PI3K) and phosphorylated protein kinase B (Akt) in gastric cancer cells (P=0.043,P<0.001),whereas disruption of SNRPD1 inhibited their expression (both P<0.001).Insulin-like growth factor 1,an agonist of the PI3K/Akt signaling pathway,promoted the proliferation of gastric cancer cells with SNRPD1 disturbed (P=0.002). Conclusion High expression of SNRPD1 in the gastric cancer tissues is associated with poor prognosis,and it may promote tumor cell proliferation and regulate the cell cycle by activating the PI3K/Akt signaling pathway.
Humans
;
Stomach Neoplasms/pathology*
;
Prognosis
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Cell Line, Tumor
;
Cell Proliferation
;
Retrospective Studies
;
Cell Cycle
;
Male
;
Female
2.Effect of Afzelin on 2,4,6-Trinitrobenzene Sulfonic Acid-Induced Colitis in Mice.
Zhi-Jun GENG ; Li-Xia YIN ; Min-Zhu NIU ; Jing-Jing YANG ; Xiao-Feng ZHANG ; Jing LI
Acta Academiae Medicinae Sinicae 2025;47(2):207-218
Objective To investigate the role and mechanism of afzelin(AFZ)in treating Crohn's disease-like colitis.Methods A mouse model of 2,4,6-trinitrobenzene sulfonic acid-induced colitis was established to assess the effect of AFZ on experimental colitis in vivo.A Caco-2 cell model of tumor necrosis factor(TNF)-α-induced inflammation was established to evaluate the effects of AFZ on the intestinal barrier function,intestinal epithelial cell apoptosis,and mitochondrial function in vitro.The animal and cell experiments were performed to validate the regulatory role of the adenosine monophosphate-activated protein kinase(AMPK)/silent information regulater 1(SIRT1)/peroxisome proliferator-activated receptor gamma coactivator(PGC)-1α pathway in the treatment of colitis with AFZ.Results AFZ reduced the disease activity index(P=0.003),weight loss(P<0.001),colon shortening(P<0.001),inflammation score(P=0.002),pro-inflammatory cytokine release(interleukin-6:P<0.001;TNF-α:P=0.010),and intestinal barrier permeability(fluorescein isothiocyanate dextran 4:P<0.001;intestinal-type fatty acid-binding protein:P=0.013).Meanwhile,AFZ increased the colonic transepithelial electric resistance(P=0.001),reduced bacterial translocation(P<0.001),and promoted the localization and up-regulated the expression of tight junction proteins [zonula occluden-1(P=0.005) and Claudin-1(P=0.024)].AFZ exerted a protective effect on the Caco-2 cells exposed to TNF-α in terms of intestinal epithelial cell permeability(P=0.017),transepithelial electric resistance(P=0.014),and tight junction protein[zonula occluden-1(P=0.014) and Claudin-1(P=0.006)] localization and expression.Furthermore,the cell and animal experiments confirmed that AFZ reduced the percentage of apoptosis(P<0.001,P=0.013)and the expression of cleaved-caspase 3(P=0.028,P=0.004)and Bax(P=0.004,P=0.020),and upregulated the Bcl2(P=0.020,P=0.006)level in intestinal epithelial cells.Additionally,AFZ increased the number of mitochondria,mitochondrial membrane potential,and copy number of mitochondrial DNA(P=0.007)in intestinal epithelial cells,while enhancing the activities of mitochondrial respiratory chain complex Ⅰ(P=0.005)and complex Ⅳ(P=0.001).The activation of the AMPK/SIRT1/PGC-1α pathway was involved in the protective effects of AFZ on mitochondrial function and apoptosis in intestinal epithelial cells.Conclusion AFZ alleviates mitochondrial dysfunction and apoptosis in intestinal epithelial cells by activating the AMPK/SIRT1/PGC-1α pathway,thereby ameliorating intestinal barrier dysfunction and experimental colitis.
Animals
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Colitis/drug therapy*
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Humans
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Caco-2 Cells
;
Mice
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Trinitrobenzenesulfonic Acid
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Apoptosis/drug effects*
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Disease Models, Animal
;
AMP-Activated Protein Kinases/metabolism*
;
Sirtuin 1/metabolism*
3.Clinical trial of remifentanil combined with dexmedetomidine in orthopedic surgery for the elderly patients
Zhi-Min ZHANG ; Yong-Le LI ; Xiao-Long NIU ; Guang-Yi WU ; Ying WANG ; Lu GAN
The Chinese Journal of Clinical Pharmacology 2024;40(2):190-194
Objective To investigate the effects of remifentanil and dexmedetomidine controlled hypotension on coagulation function,cerebral oxygen metabolism and amino acid neurotransmitter levels in elderly patients undergoing orthopedic surgery.Methods The elderly patients who underwent lower extremity orthopedic surgery were divided into group A(given dexmedetomidine for hypotension),group B(given remifentanil for hypotension)and group C(given remifentanil combined with dexmedetomidine for hypotension)according to different anesthetic drugs.Systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)were compared among the 3 groups.Cerebral oxygen metabolism[arterial oxygen content,(CaO2),oxygen saturation of internal jugular vein(SjvO2),oxygen content of internal jugular vein(CjvO2)],coagulation function[activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),plasma fibrinogen(FIB)],amino acid neurotransmitters[glutamic acid(Glu),aspartate(Asp),gamma-aminobutyric acid(GABA)]were compared,and the occurrence of adverse drug reactions during the trial were compared.Results At 12 h after anesthesia,the APTT of group A,group B and group C were(17.26±2.77),(17.37±2.92)and(31.11±4.74)s,respectively.GABA were(18.74±2.71),(19.22±2.60)and(23.37±2.59)mmol·L-1,respectively.3 min after withdrawal,CaO2 in group A,group B and group C were(139.31±9.03),(140.90±8.70)and(131.75±10.11)mL·L-1,respectively;SjvO2 were(63.59±2.23)%,(63.40±2.44)%and(68.82±3.36)%,respectively.The above indexes of group C were compared with those of group A and group B,and the differences were statistically significant(all P<0.05).The incidence of adverse drug reactions in group A,B and C were 12.82%,27.50%and 7.32%,respectively.The incidence of adverse drug reactions in group C were lower than that in group A and group B(P<0.05).Conclusion Remifentanil combined with dexmedetomidine for controlled hypotension in elderly orthopedic surgery has better blood pressure control effect,can improve postoperative coagulation function,maintain cerebral oxygen metabolism balance,reduce cognitive function injury and anesthesia adverse drug reactions.
4.Research status of pharmacological mechanism of PCSK9 inhibitors and discussion of their clinical application
Wen-Hui MO ; Si-Lei XU ; Xia HE ; Niu-Niu BAI ; Meng-Ying YUAN ; Zhi-Min LI ; Jiao ZHANG ; Fei WANG ; Yuan-Kun ZHENG
The Chinese Journal of Clinical Pharmacology 2024;40(16):2438-2441
Atherosclerosis caused by disorders of lipid metabolism is the main pathological basis of atherosclerotic cardiovascular disease.Statins are the cornerstone of lipid-modulating therapy for this type of disease,but in practice there are still some patients with suboptimal lipid management.Proprotein convertase subtilisin/kexin type 9(PCSK9)inhibitors have been gradually applied as a new class of lipid-modulating drugs for the treatment in patients with this type of disease,and recent studies have shown that in addition to regulating lipid metabolism,PCSK9 inhibitors also have potential anti-inflammatory and anti-platelet activation effects.This article sorts out the multiple pharmacological mechanisms of action of PCSK9 inhibitors and the current status of clinical research of PCSK9 inhibitors.Besides,it discusses the factors that may affect the efficacy of PCSK9 inhibitors,in order to provide a reference for the safe and rational medication of PCSK9 inhibitors.
5.Predicted 10-year Cardiovascular Disease Risk and Its Association with Sleep Duration among Adults in Beijing-Tianjin-Hebei Region, China.
Yu Xue WANG ; Li ZHANG ; Chun Jun LI ; Xin QI ; Ya Qi FAN ; Jiang Shan HE ; Pei GUO ; Jia Lin HU ; Shuo CHEN ; Yu Jie NIU ; Feng LIU ; Rong ZHANG ; Qiang LI ; Shi Tao MA ; Mian Zhi ZHANG ; Cheng Lin HONG ; Min Ying ZHANG
Biomedical and Environmental Sciences 2021;34(10):803-813
Objective:
The study aims to predict 10-year cardiovascular disease (CVD) risk and explore its association with sleep duration among Chinese urban adults.
Methods:
We analyzed part of the baseline data of a cohort that recruited adults for health screening by cluster sampling. The simplified Pittsburgh Sleep Quality Index (PSQI) and Framingham 10-year risk score (FRS) were used to measure sleep duration and CVD risk. Demographic characteristics, personal history of chronic diseases, lifestyle factors were collected using a questionnaire. Height, weight, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were also measured. Multiple logistic regression models were performed to explore the association of sleep duration with the predicted CVD risk.
Results:
We included 31, 135 participants (median age 44 years, 53.02% males) free of CVD, cerebral stroke, and not taking lipid-lowering agents. Overall, 14.05%, and 25.55% of participants were at medium and high predicted CVD risk, respectively. Short sleep was independently associated with increased odds of medium to high risk of predicted 10-year CVD among males (
Conclusion
A substantial number of adults free of CVD were at high 10-year CVD risk. Short sleep was associated with increased odds of predicted CVD risk.
Adult
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Aged
;
Aged, 80 and over
;
Cardiovascular Diseases/etiology*
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China/epidemiology*
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Female
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Humans
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Male
;
Middle Aged
;
Risk Factors
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Sleep Quality
;
Young Adult
6.Genome-wide 5-Hydroxymethylcytosine Profiling Analysis Identifies MAP7D1 as A Novel Regulator of Lymph Node Metastasis in Breast Cancer
Wu SHUANG-LING ; Zhang XIAOYI ; Chang MENGQI ; Huang CHANGCAI ; Qian JUN ; Li QING ; Yuan FANG ; Sun LIHONG ; Yu XINMIAO ; Cui XINMIAO ; Jiang JIAYI ; Cui MENGYAO ; Liu YE ; Wu HUAN-WEN ; Liang ZHI-YONG ; Wang XIAOYUE ; Niu YAMEI ; Tong WEI-MIN ; Jin FENG
Genomics, Proteomics & Bioinformatics 2021;19(1):64-79
Although DNA 5-hydroxymethylcytosine (5hmC) is recognized as an important epige-netic mark in cancer, its precise role in lymph node metastasis remains elusive. In this study, we investigated how 5hmC associates with lymph node metastasis in breast cancer. Accompanying with high expression of TET1 and TET2 proteins, large numbers of genes in the metastasis-positive pri-mary tumors exhibit higher 5hmC levels than those in the metastasis-negative primary tumors. In contrast, the TET protein expression and DNA 5hmC decrease significantly within the metastatic lesions in the lymph nodes compared to those in their matched primary tumors. Through genome-wide analysis of 8 sets of primary tumors, we identified 100 high-confidence metastasis-associated 5hmC signatures, and it is found that increased levels of DNA 5hmC and gene expression of MAP7D1 associate with high risk of lymph node metastasis. Furthermore, we demonstrate that MAP7D1, regulated by TET1, promotes tumor growth and metastasis. In conclusion, the dynamic 5hmC profiles during lymph node metastasis suggest a link between DNA 5hmC and lymph node metastasis. Meanwhile, the role of MAP7D1 in breast cancer progression suggests that the metastasis-associated 5hmC signatures are potential biomarkers to predict the risk for lymph node metastasis, which may serve as diagnostic and therapeutic targets for metastatic breast cancer.
7.Ideal Cardiovascular Health is Inversely Associated with Subclinical Atherosclerosis: A Prospective Analysis.
Long WANG ; Jing Ya NIU ; Zhi Yun ZHAO ; Mian LI ; Min XU ; Jie Li LU ; Tian Ge WANG ; Yu Hong CHEN ; Shuang Yuan WANG ; Meng DAI ; Lin LI ; Shan Shan LIU ; Wei Qing WANG ; Yu XU ; Yu Fang BI
Biomedical and Environmental Sciences 2019;32(4):260-271
OBJECTIVE:
Ideal cardiovascular health (CVH) could predict a lower risk of developing cardiovascular diseases. This study was conducted to investigate the association between ideal CVH and subclinical atherosclerosis in a population cohort of Chinese adults aged ⪖ 40 years.
METHODS:
This study was designed as a cross-sectional analysis of 8,395 participants who had complete data at baseline and a prospective analysis of 4,879 participants who had complete data at 4.3 years of follow-up. Ideal CVH metrics were defined according to the American Heart Association. Subclinical atherosclerosis was evaluated by plaques in carotid arteries, carotid intima-media thickness (CIMT), brachial-ankle pulse wave velocity (baPWV), and urinary albumin-to-creatinine ratio (UACR).
RESULTS:
Both the prevalence and incidence of atherosclerosis measures were found to be decreased with increasing numbers of ideal CVH metrics at baseline (all P values for trend < 0.01). The levels of CIMT and UACR at follow-up showed an inverse and significant association with the numbers of ideal CVH metrics at baseline (both P values for trend < 0.05) but a borderline significant association with baPWV (P for trend = 0.0505). Taking participants with 0-1 ideal metric as reference, we found that participants with 5-6 ideal metrics had significantly lower risks of developing carotid plaques (odds ratio, OR = 0.46; 95% confidence interval, CI 0.27-0.79), increased CIMT (OR = 0.60; 95% CI 0.42-0.84), and increased baPWV (OR = 0.57; 95% CI 0.34-0.97) after full adjustments. A significant interactive effect of age and CVH was detected on CIMT and baPWV progression (both P values for interaction < 0.05).
CONCLUSION
The numbers of ideal CVH metrics showed a significant and inverse association with the risk of developing subclinical atherosclerosis in middle-aged and elderly Chinese adults, whereas its dose-response effect was attenuated in individuals aged ≥ 60 years and partially weakened in male participants.
Aged
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Atherosclerosis
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epidemiology
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China
;
epidemiology
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Cross-Sectional Studies
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Female
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Health Status
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Humans
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Male
;
Middle Aged
;
Prospective Studies
8. Role of vaginal microbial metabolites and enzymes and high risk HPV in the development of cervical intraepithelial neoplasia
Ruo-xi ZHU ; Min HAO ; Wei-hong ZHAO ; Wei WANG ; Zhi-lian WANG ; Jin-tao WANG ; Bo FENG ; Jing YANG ; Zhe WANG ; Xiao-fen NIU
Chinese Journal of Practical Gynecology and Obstetrics 2019;35(07):797-802
OBJECTIVE: To investigate the role of vaginal microbial metabolites and enzyme changes and high-risk human papillomavirus(HR-HPV)infection in cervical intraepithelial neoplasia(CIN)and their interaction effects.METHODS: From June 2014 to December 2014,demographic characteristics and CIN-related factors and cervical liquid-based cytology(TCT)examination results were collected from 40 000 community-based populations from two regions of Shanxi Province by the Second Hospital of Shanxi Medical University.Patients who meet the criteria for enrollment were further tested for vaginal microecology,HPV testing,and colposcopic and pathologic examination.A total of 782 cases with pathological diagnosis of CIN were chosen as the case group;1503 patients with normal pathological results were chosen as a control group.A multivariate logistic regression model was established to analyze the vaginal microbial metabolic enzymes cross-sectionally,then the association between vaginal microbial metabolic changes and CIN risk was evaluated.RESULTS: The expression of hydrogen peroxide(H2 O2),β-glucuronidase(GUS)and sialidase(SNA)was statistically correlated with CIN risk,and the odd ratios were 1.60(95% CI 1.30-1.96),1.58(95% CI 1.30-1.92),and 1.45(95% CI1.18-1.79),respectively.The expression of acetylglucosaminidase(NAG)and leukocyte esterase(LE)had no statistical association with CIN risk.Interaction analysis showed that there were positive multiplicative interactions among H2 O2,GUS,SNA and HR-HPV infections in the occurrence of CIN.CONCLUSION: Positive H2 O2,GUS,and SNA is associated with increased risk of CIN,and they have positive interaction with HR-HPV infection,which increases the risk of CIN.
9.External Quality Analysis of Quality Indicators on Specimen Acceptability
Yuan-Yuan YE ; Wei WANG ; Hai-Jian ZHAO ; Feng-Feng KANG ; Wei-Xing LI ; Zhi-Ming LU ; Wei-Min ZOU ; Yu-Qi JIN ; Wen-Fang HUANG ; Bin XU ; Fa-Lin CHEN ; Qing-Tao WANG ; Hua NIU ; Bin-Guo MA ; Jian-Hong ZHAO ; Xiang-Yang ZHOU ; Zuo-Jun SHEN ; Wei-Ping ZHU ; Yue-Feng L(U) ; Liang-Jun LIU ; Lin ZHANG ; Li-Qiang WEI ; Xiao-Mei GUI ; Yan-Qiu HAN ; Jian XU ; Lian-Hua WEI ; Pu LIAO ; Xiang-Ren A ; Hua-Liang WANG ; Zhao-Xia ZHANG ; Hao-Yu WU ; Sheng-Miao FU ; Wen-Hua PU ; Lin PENG ; Zhi-Guo WANG
Journal of Modern Laboratory Medicine 2018;33(2):134-138,142
Objective To analyze the status of quality indicators(QI) on specimen acceptability and establish preliminary qual ity specification.Methods Web based External Quality Assessment system was used to collect data of laboratories partici pated in "Medical quality control indicators in clinical laboratory" from 2015 to 2017,including once in 2015 and 2017 and twice in 2016.Rate and sigma scales were used to evaluate incorrect sample type,incorrect sample container,incorrect fill level and anticoagulant sample clotted.The 25th percentile (P25) and 75th percentile (P75) of the distribution of each QI were employed to establish the high,medium and low specification.Results 5 346,7 593,5 950 and 6 874 laboratories sub mitted the survey results respectively.The P50 of biochemistry (except incorrect fill level),immunology and microbiology reach to 6σ.The P50 of clinical laboratory is 4 to 6σ except for incorrect sample container.There is no significant change of the continuous survey results.Based on results in 2017 to establish the quality specification,the P25 and P75 of the four QIs is 0 and 0.084 4 %,0 and 0.047 6 %,0 and 0.114 2 %,0 and 0.078 4 %,respectively.Conclusion According to the results of the survey,most laboratories had a faire performance in biochemistry,immunology and microbiology,and clinical laboratory needs to be strengthened.Laboratories should strengthen the laboratory information system construction to ensure the actual and reliable data collection,and make a long time monitoring to achieve a better quality.
10.Three-year Follow-up on the Safety and Effectiveness of Rituximab Plus Chemotherapy as First-Line Treatment of Diffuse Large B-Cell Lymphoma and Follicular Lymphoma in Real-World Clinical Settings in China: A Prospective, Multicenter, Noninterventional Study.
Jian-Qiu WU ; Yong-Ping SONG ; Li-Ping SU ; Ming-Zhi ZHANG ; Wei LI ; Yu HU ; Xiao-Hong ZHANG ; Yu-Huan GAO ; Zuo-Xing NIU ; Ru FENG ; Wei WANG ; Jie-Wen PENG ; Xiao-Lin LI ; Xue-Nong OUYANG ; Chang-Ping WU ; Wei-Jing ZHANG ; Yun ZENG ; Zhen XIAO ; Ying-Min LIANG ; Yong-Zhi ZHUANG ; Ji-Shi WANG ; Zi-Min SUN ; Hai BAI ; Tong-Jian CUI ; Ji-Feng FENG
Chinese Medical Journal 2018;131(15):1767-1775
Background:
Prospective real-life data on the safety and effectiveness of rituximab in Chinese patients with diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma (FL) are limited. This real-world study aimed to evaluate long-term safety and effectiveness outcomes of rituximab plus chemotherapy (R-chemo) as first-line treatment in Chinese patients with DLBCL or FL. Hepatitis B virus (HBV) reactivation management was also investigated.
Methods:
A prospective, multicenter, single-arm, noninterventional study of previously untreated CD20-positive DLBCL or FL patients receiving first-line R-chemo treatment at 24 centers in China was conducted between January 17, 2011 and October 31, 2016. Enrolled patients underwent safety and effectiveness assessments after the last rituximab dose and were followed up for 3 years. Effectiveness endpoints included progression-free survival (PFS) and overall survival (OS). Safety endpoints were adverse events (AEs), serious AEs, drug-related AEs, and AEs of special interest. We also reported data on the incidence of HBV reactivation.
Results:
In total, 283 previously untreated CD20-positive DLBCL and 31 FL patients from 24 centers were enrolled. Three-year PFS was 59% (95% confidence interval [CI]: 50-67%) for DLBCL patients and 46% (95% CI: 20-69%) for FL patients. For DLBCL patients, multivariate analyses showed that PFS was not associated with international prognostic index, tumor maximum diameter, HBV infection status, or number of rituximab treatment cycles, and OS was only associated with age >60 years (P < 0.05). R-chemo was well tolerated. The incidence of HBV reactivation in hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative/hepatitis B core antibody-positive patients was 13% (3/24) and 4% (3/69), respectively.
Conclusions:
R-chemo is effective and safe in real-world clinical practice as first-line treatment for DLBCL and FL in China, and that HBV reactivation during R-chemo is manageable with preventive measures and treatment.
Trial Registration
ClinicalTrials.gov, NCT01340443; https://clinicaltrials.gov/ct2/show/NCT01340443.
Aged
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Aged, 80 and over
;
Antineoplastic Combined Chemotherapy Protocols
;
therapeutic use
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China
;
Cyclophosphamide
;
administration & dosage
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Doxorubicin
;
administration & dosage
;
Female
;
Follow-Up Studies
;
Humans
;
Lymphoma, Follicular
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drug therapy
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Lymphoma, Large B-Cell, Diffuse
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drug therapy
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Male
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Middle Aged
;
Prospective Studies
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Rituximab
;
therapeutic use
;
Vincristine
;
administration & dosage

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