Objective:To search the best evidence for perioperative nutrition management in pancreatic cancer patients, so as to provide evidence basis for optimization of perioperative nutrition management in pancreatic cancer patients.Methods:Evidence on perioperative nutrition management for pancreatic cancer patients was systematically searched in Cochrane Library, British Medical Journal (BMJ) Best Practice, UpToDate, National Institute for Health and Clinical Excellence, PubMed, China National Knowledge Infrastructure, WanFang Data, VIP, Chinese Medical Association Network and other domestic and foreign databases and nutrition related websites. The search types included clinical decision-making, guidelines, expert consensus, evidence summary, and systematic review. The search period was from database establishment to February 10, 2023.Results:A total of 17 articles were included, including 8 guidelines, 6 expert consensus, and 3 systematic reviews. A total of 26 pieces of evidence were summarized from 6 aspects, including management general principles, energy and protein requirements, nutritional risk screening and assessment, nutritional support, complication management, and post discharge management.Conclusions:The process of extracting the best evidence of perioperative nutrition management for pancreatic cancer patients is scientific and rigorous. Medical and nursing staff can improve the quality of nutrition management for patients with pancreatic cancer and promote the recovery of patients according to the actual clinical situation.

Objective:This study aims to explore the clinical characteristics of T-cell large granular lymphocyte leukemia (T-LGLL) patients with STAT3 mutation status and provide a reference for clinical management of such patients.Methods:The clinical data of T-LGLL patients between 2009 and 2019 in Jiangsu Province Hospital were retrospectively analyzed. Differences in baseline clinical data, treatment responses, and survival outcomes in patients with STAT3 mutations or with no mutations were compared.Results:A total of 80 patients were included, including 66 patients without STAT3 mutation and 14 patients (17.5%) with STAT3 mutation. The frequency of Y640F mutation was the highest (42.9%) . Compared with non STAT3 mutation group, STAT3 mutation group had lower HGB (67.5 g/L vs 82.5 g/L, P=0.018) , lower neutrophil count (0.665×10 9/L vs 1.465×10 9/L, P<0.001) , higher LDH (229 U/L vs 198 U/L, P=0.041) , higher ferritin (402.5 g/L vs 236.0 g/L, P=0.029) , higher expression rate of TCR Vβ subfamily (89.2% vs 65.4%, P=0.014) and higher proportion of patients with treatment indications (100% vs 74%, P=0.033) . The complete remission rates of STAT3 mutation group and non mutation group were 38.5% and 32.7%, respectively, with no significant difference ( P=0.748) . The overall response rate of first-line immunosuppressive therapy in STAT3 mutation group and non mutation group were 69.2% and 69.4%, respectively, with no significant difference ( P=1.000) . The median follow-up time was 63 (2-121) months. There was no significant difference in the overall survival time between the two groups ( P=0.170) . Conclusions:T-LGLL patients with STAT3 mutations seems to be correlated with an increased tumor burden and high treatment demand, and had a good response to first-line immunotherapies. The prognostic significance of STAT3 mutation in T-LGLL patients requires further validation.

Objective:This study aims to investigate the expression of E3 ubiquitin-ligase (WWP1) in chronic lymphocytic leukemia (CLL) patients and analyze its correlation with clinical prognostic indicators (TP53, CD38, IGHV mutation) and its prognostic value.Methods:A total of 48 CLL patients and 9 age-matched normal subjects were enrolled in the study. The WWP1 expression was detected by SYBR Green-based real-time PCR, and the clinical relationship was analyzed by GraphPad Prism software.Results:The WWP1 median expression was 0.007 (95% CI 0.005-0.010) in the normal control group and 0.031 (95% CI 0.019-0.044) in the CLL group ( P<0.001) . A sub-groups analysis implicated a statistically significant result ( P=0.022) , showing that the median time from a relatively high and low transcription level of WWP1 to the first treatment was 24 months and 35 months, respectively. Positive CD38 and ZAP-70 expressions were associated with a higher WWP1 expression ( P=0.012 and 0.029, respectively) . Conclusion:An abnormal WWP1 mRNA expression was found in CLL patients with significant correlation with ZAP-70 and CD38 expressions, and WWP1 may become a new supplement of CLL prognostic markers.

Objective]To evaluate the reliability and validity of Chinese version of the Pediatric Quality of Life Inventory PedsQL multidimensional fatigue scale among short stature.[Methods]The Cross-sectional surveys was made using this Chinese scale. A total of 570 children and adolescents and their parents were investigated. 522 valid questionnaires were collected,of which 138 were short stature and 384 with normal height ,Analysis feasibility ,reliability and validity of this Chinese version scale.[Results]Cronbach alpha coefficients of the parent-proxy report was 0.89,the dimensions ranged from 0.75 to 0.87,Cronbach alpha coefficients of the child self-report was 0.86,the dimensions ranged from 0.70 to 0.80;Test retest reliability was satisfied for intra-class correlation coefficient(ICC)exceeded 0.9 in all dimensions. Correlation coefficients between items and their belong dimensions higher than those with other dimensions;The result of confirmatory factor analysis indicated the main indexes χ2/df = 2.62,CFI =0.93,TLI=0.92,NFI=0.89,RFI=0.87,IFI=0.93,RMSEA=0.056 of self-report andχ2/df=3.12,CFI=0.94,TLI=0.92, NFI=0.91,RFI=0.89,IFI=0.94,RMSEA=0.064 of proxy-report all met the criteria of psychometrics.[Conclusion]The Chinese version of PedsQL Multidimensional Fatigue Scale has good feasibility ,reliability and validity ,and can be used to evaluate the fatigue of short stature in children and adolescents in Chinese cultural background.

Objective To study the socialization character of the examinee in entrance examination of medical postgraduate.Methods 48 examinee in physical fitness test and 496 examinee in entrance examination of medical postgraduate were investigated by applying minnesota multiphasic personality inventory ( MMPI ).Results ①Female postgraduate entrance examinee had higher scores of social responsibility and absence of social anxiety ( H1 ) than male ( 59.1 ± 9.0 vs 56.0 ± 8.5, 59.0 ± 10.1vs 57.3 ± 8.6, P ＜ 0.05 ).Graduates had higher scores of absence of social anxiety( H1 ) (58.3 ±9.4 vs 52.1 ± 11.5, P＜0.05 ), lower scores of alienation from the society(PD4A) and alienation from the society(S1 A) (44.2 ±7.6 vs 51.7 ±9.0, 39.6 ±7.4 vs 45.9 ±9.6,P＜0.05) than junior college graduates.The unmarried persons had higher scores of alienation from the society (PD4A) than the married persons (44.7±7.7 vs 42.9±7.1,P<0.05).②After controlling the effect of gender,marital status and education level, covariance analysis demonstrated that postgraduate entrance examinee had higher scores of S1A (40.0 ±7.5 vs35.2 ±6.8, P＜0.05).Conclusion There are significant differences of socialization character among postgraduate entrance examinee with the difference of genders, marital status and education level.Postgraduate entrance examinee prefers alienation from the society.

AIM: To develop a simple and sensitive high-performance liquid chromatography (HPLC) for the quantification of zidovudine and to study the pharmacokinetics of two kinds of zidovudine capsules in Chinese healthy volunteers. METHODS :The concentrations of zidovudine in plasma were determined by a validated HPLC method with UV detection. A randomized two-way crossover study was conducted in 18 fasting volunteers to compare plasma pharmacokinetic profile and single-dose tolerability of a new zidovudine capsules. RESULTS: The main pharmacokinetic parameters of two formulations, reference and test capsules, were as follows: cmax were (2 252±s 837) μg·L-1 and (2 300±1 099) μg·L-1; tmax were (0.49±0.19) h and (0.5±0.3) h;t1/2 ke were (0.93±0.19) h and (0.99±0.24) h; AUC0-t were (2 530±452) μg·h·L-1 and (2 467±605) μg·h·L-1;AUC0-∞ were(2 689 ± 414) μg·h·L-1 and (2 583±575) μg·h·L-1. The results of ANOVA and two one-side t test statistical analysis for lg AUC0-t, lg AUC0-∞ and lg cmax showed that two formulations were bioequivalent. CONCLUSION:The method is convenient, sensitive, accurate and reproducible, and could be applied to determining the plasma zidovudine concentration and studying on pharmacokinetics. Two zidovudine capsules are bioequivalent in Chinese healthy volunteers.

AIM: To establish a method to determine the concentration of indinavir in human plasma and study indinavir bioavailability in Chinese healthy people. METHODS: In a random two-period crossover study, 18 healthy male volunteers received a single dose of indinavir capsules 800 mg of two formulations respectively.A sensitive and specific reversed phase HPLC method was developed to quantitate plasma levels of indinavir. The drug was extracted from plasma with acetonitrile. Analysis was performed on a Hy persil C18 column with a mobile phase of acetonitrile:0.01 mol · L -1 phosphate buffer(pH 5.5 ) (43: 57).The UV detector was set at 210 nm. The standard curve covered the concentration ranged from 0. 03 to 16.38 mg · L-1. RESULTS: The concentration-time curves of reference and tested formulations both fitted to a one-compartment open model. The main pharmacokinetic rameters of tested and reference formulations were (10.6 ±s 2.4) mg· L-1 and (9.8 ±2.2)mg· L-1 for cmax, (0. 71 ± 0. 19) h and (0. 8 ±0.3) h for tmax, (1.30±0.24) h and (1.31 ±0.23) h for t1/2ke, (23±6) mg·h· L-1 and (22±5) mg·h · L-1 forAUC0-10, (24±6) mg · h · L-1 and (22±5) mg · h · L-1 for AUC0-∞, respectively. Two one-sidet test and variance analysis were performed in bioequivalent assessment. No statistically significant difference was found in AUC0-10, AUC0-∞ and cmax values between the tested and reference formulations. CONCLUSION:The reversed phase HPLC is a reliable method to determine the concentration of indinavir in human plasma and the two formulations of indinavir are bioequivalent.

OBJECTIVETo investigate the mechanism(s) of penicillins allergic reaction.

METHODSThe radioallergosorbent test (RAST) was used to detect 9 specific IgE antibodies, including major antigenic determinants: benzylpenicilloyl (BPO), ampicilloyl (APO), amoxicilloyl (AXO), phenoxomethylpenicilloyl (PVO) and flucloxacilloyl (FLUO), and minor antigenic determinants: benzylpenicillanyl (BPA), amoxicillanyl (AXA), 6-aminopenicillanic (APA) and phenoxomethylpenicillany (PVA), in the sera of 32 penicillin allergic patients. The relationship between specific IgE antibodies and penicillins chemical structures was studied by radioallergosorbent inhibition test.

RESULTSNineteen of 32 patients (59.4%) were RAST positive, among whom, five cases were positive only to one or two antigenic minor determinants, and three cases were positive only to one or three major antigenic determinants. The remaining 11 patients were positive not only to major antigenic determinants but also minor antigenic determinants. In 9 specific IgE antibodies, the positive rate of PVA-IgE was the highest (34.38%), followed by BPO-IgE (31.25%). The positive rate of FLUO-IgE was the lowest (15.63%). Of the total patient group, 53.13% were positive to one or more minor antigenic determinants, while 37.5% (12/32) were positive to one or more major antigenic determinants. The percentage of patients with urticarial reactions who were positive to minor antigenic determinants (63.16%) was significantly higher than observed in the anaphylactic shock group (38.5%, P < 0.05).

CONCLUSIONSThe minor antigenic determinant was important in allergic reaction. The combining sites of the specific IgE antibodies were likely to be the side-chain of drug or the overwhelming drug molecule.

Adolescent ; Adult ; Aged ; Antibodies ; blood ; Drug Hypersensitivity ; immunology ; Epitopes ; immunology ; Female ; Humans ; Immunoglobulin E ; blood ; Male ; Middle Aged ; Penicillins ; immunology ; Radioallergosorbent Test

Aim To evaluate the value of expressions of CD63 on basophils in diagnosing allergy to penicillins.Methods The expressions of CD63 on basophils activated with 9 kinds of antigens(PG:penicillin G,PV:phenoxomethylpenicillin,AMP:ampicillin,AX:amoxicilloyl,6-APA:6-aminopenicillanic acid,PHA:phenylacetic acid,PHOA:phenoxacetic acid,PHPG:N-(?-hydroxyphenyl)glycine,NPG:N-phenylglycine) were detected by FAST(Flow cytometric allergen stimulation test) in 43 patients with penicillins allergy.Eight types of specific IgE and IgG antibodies to penicillins were determinated by RAST and ELISA,respectively.Results The sensitivity and specificity of CD63 used as a marker in patients with penicillins allergy were 65.12% and 93.33%,respectively.Moreover,the sensitivities of CD63 and specific IgE were higher than those of specific IgG in patients with positive skin test(P

Aim To elucidate the relationship between IgG antibodies and penicillin allergy.Methods Enzyme-linked immunosorbent assay was used to examine 8 kinds of specific IgG antibodies,including major antigenic determinants:benzylpenicilloyl(BPO),ampicilloyl(APO),amoxicilloyl(AXO)and phenoxomethylpenicilloyl(PVO),and minor antigenic determinants:benzyl-penicillanyl(BPA),amoxicillanyl(AXA),ampicillanyl(APA)and phenoxomethylpenicillany(PVA),in the sera of 241 patients with penicillin allergy.Results Except BPA-IgG,levels of 7 kinds of antigenic determinants IgG antibodies were significantly higher than those of control group(P