The clinical data of two children with refractory/relapsed acute B-lymphoblastic leukemia (ALL-B)treated with Blinatumomab in Department of Pediatrics, Peking University People′s Hospital from September 2019 to May 2021 were retrospectively analyzed.After 1 course of Blinatumomab infusion, both children achieved complete hematologic remission.During the infusion process, grade 2 cytokine release syndrome (CRS) was observed, and there were no fatal adverse reactions.One case underwent bridging hematopoietic stem cell transplantation after remission and achieves disease-free survival currently.The other case is still alive after subsequent consolidation chemotherapy.As a novel bispecific antibody, Blinatumomab has a good response rate to refractory/relapsed ALL-B and induces fewer adverse events, so it can be used as a candidate immunotherapy for patients with high tumor burden.

Objective:To observe the clinical effect on patients of invasive ductal carcinoma of the breast by neoadjuvant chemotherapy, and to analyze the changes of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2) and Ki67 in neoplasm.Methods:A total of 83 patients which were treated by neoadjuvant chemotherapy in breast invasive ductal carcinoma diagnosed were selected in North China University of Science and Technology Affiliated Hopital from January 2014 to December 2020. There were 30 cases of Luminal type A, 31 cases of Luminal type B, 10 cases of HER-2 positive type and 12 cases of triple negative type. To observe the clinical effect of different molecular subtypes, detect the expression of Er, PR, HER-2 and Ki67 in pathological tissues before and after neoadjuvant chemotherapy, and conduct a retrospective case-control study. Comparison between the two groups use χ2 test, matched χ2 and accurate probability method. Results:Fifty-eight cases were clinically effective, the total effective rate was 69.8% (58/83), and 9 cases were pathological complete response (pCR), accounting for 10.8% (9/83). After neoadjuvant chemotherapy, the highest clinical efficacy was luminal type B in 26 cases, and the highest PCR was triple negative type in 3 cases. The pathological results showed that the expression of ER (6 cases of positive expression were increased, χ2=1.03, P=0.310), PR (8 cases of positive expression were increased, χ2=1.56, P=0.210) and HER-2 (2 cases of positive expression were decreased, χ2=0.10, P=0.748) was not different before and after neoadjuvant chemotherapy. The expression of Ki67 was decreased in 25 cases (30.1%) after chemotherapy compared with 59 cases (71.1%) before chemotherapy (34 cases of positive expression were decreased, χ2=27.85, P<0.001). Five cases were added among Luminal type A after chemotherapy, all of which were transformed from Luminal type B, but the kappa value was 0.919 (>0.75), the consistency rate was 91.9%. The consistency was idea before and after chemotherapy. Five cases were added after Luminal type A chemotherapy, all of which were transformed from Luminal type B, but the kappa value was 0.919 ( P>0.75), and the consistency rate was 91.9%,The consistency before and after chemotherapy was good. After chemotherapy, HER-2 expression remained unchanged in 59 cases (clinically effective in 48 cases), up-regulated in 9 cases (clinically effective in 4 cases) and down regulated in 15 cases (clinically effective in 6 cases)( χ2=12.82, P=0.002). Ki67 expression remained unchanged in 35 cases (20 cases were clinically effective), up-regulated in 7 cases (2 cases were clinically effective) and down regulated in 41 cases (36 cases were clinically effective)( χ2=14.63, P=0.001). Conclusion:The clinical effect of neoadjuvant chemotherapy in the treatment of breast invasive ductal carcinoma is ideal. The clinical effective rate of Luminal B type is the highest, and the pCR rate of triple negative type is the highest.And it can significantly reduce the expression of Ki67. The down-regulation of HER-2 and Ki67 is significant for clinical efficiency.

OBJECTIVE： To study the effects and mechanism of Le’ermai capsule on oxidative stress injury in the cerebral cortex of cerebral ischemia-reperfusion injury rats. METHODS： Totally 65 rats were randomly divided into sham operation group （normal saline）， model group （normal saline）， positive control group （Naoxintong capsule， 3.40 g/kg）， Le’ermai capsule high-dose and low-dose groups （0.37， 0.18 g/kg）， with 13 rats in each group. Except that sham operation group received sham operation， and middle cerebral artery occlusion/reperfusion （MCAO/R） model was induced by suture-occluded method. 24 h after modeling， they were given relevant medicine intragastrically， once a day， for consecutive 7 d. 2 h after last administration， cerebral ischemic area was determined by TTC staining. The pathological changes of cerebral tissue were observed by HE staining. The protein expressions of HO-1， SOD1， SOD2 and Nrf2 in cerebral cortex were detected by Western blot assay. RESULTS： Compared with sham operation group， the area of cerebral ischemic was increased significantly in model group（P＜0.05）， interstitial edema was serious， inflammatory cell infiltration increased significantly； and the protein expression levels of HO-1 and SOD1 in cortex tissue were significantly increased （P＜0.05）， and the protein expression levels of SOD2 and Nrf2 were significantly decreased （P＜0.05）. Compared with model group， the area of cerebral ischemic area of Le’ermai capsule high-dose and low-dose groups were significantly decreased （P＜0.05）. The interstitial edema， inflammatory cell infiltration and microcytes proliferation were decreased. The protein expression levels of HO-1， SOD1， SOD2 and Nrf2 in the cerebral cortex tissue were significantly increased （P＜0.05）. CONCLUSIONS：Le’ermai capsule can improve cerebral ischemia/reperfusion injury to certain extent， and which may be associated with up-regulating the protein expression of antioxidant factors HO-1， SOD1， SOD2 and Nrf2 in the cortex.

Objective To detect the expressions of Matrix Metalloprotein-11 ( MMP-11 ) and Cathepsin-D(Cath-D),and investigate their relationship and prognostic significance. Methods The study included 95 cases′ clinical date and postoperative specimens of gastric adenocarcinoma ( North China University of Science and Technology Affiliated Hospital,2010. 01-2013. 12) as observation group,70 cases of normal gastric tissue(from observation group) as control group. Expressions of MMP-11 and Cath-D were detected by IHC methods in two groups. Results The positive rate of MMP-11 was 51. 6%( 49/95) in observation group,5. 7%(4/70)in control group(χ2＝38. 884,P＜0. 05). The positive rate of Cath-D was 73. 7%(70/95) in observation group,28. 6%(20/70) in control group(χ2＝33. 082,P＜0. 05). The positive rate of MMP-11 was correlated with metastasis and vascular invasion(χ2＝7. 193、15. 566,P＜0. 05). The positive rate of Cath-D was correlated with maximal diameter,lymph node metastasis,vascular invasion and proliferation index(χ2＝7.431、5.654、6.569、6.801,P＜0.05).There was positive relationship between MMP-11 and Cath-D in observation group(r＝0. 46,P＜0. 05). The expressions of MMP-11 and Cath-D were correlated with prognosis in gastric adenocarcinoma ( P＜0. 05) . Conclusion The higher expressions and synergistic effect of MMP-11 and Cath-D may promote the occurrence and development in gastric adenocarcinoma. The joint detection of MMP-11 and Cath-D may be helpful to predict the prognosis of gastric adenocarcinoma.

Objective To propose on and improve direct settlements by medical insurance offices and hospital systems in their processing of medical treatment in allopatry (MTA), by analyzing such data as the homepages of medical records of such inpatients at a tertiary cancer hospital with their medical expenses settled directly. Methods Data of 6 379 MTA inpatients with direct settlements of in-hospital fees from April 2017 to March 2018 were included in this study. Such data were used to identify the change trend of their case counts and their regional distribution, and analyzed with hierarchical clustering to calculate the settlement counts of various provinces. Results Analyses found that the total cases of such patients remained stable at the hospital, yet the cases of direct settlement rose from five to 1 263, and the proportion of direct settlement among all MTA inpatients rose month by month from 0.14% to 29.26%. Most of MTA inpatients come from Hebei, Shandong, Inner Mongolia and Shanxi provinces in turn, yet the direct settlement counts and hospitalization case trends appear different. Clustering results indicate Hebei as the type-1 province with the highest proportion of direct settlement inpatients, accounting for 30. 41% ;Shandong, Inner Mongolia and Shanxi as the type-2 provinces, accounting for 15. 05% , 13. 45% and 11.00% respectively; Liaoning, Henan and Heilongjiang as the type-3 provinces, accounting for 6.79% , 4.81% and 4.42% respectively; while the rest provinces as the type-4, accounting for less than 3%. Conclusions Regional distribution varies distinctively among such inpatients, and the number of these inpatients keeps rising stably. In such circumstances, hospitals are recommended to enhance their management in strengthening medical insurance audit systems, speeding up settlement, and building regional medical alliances.

Objective To detect and analyze the expression and significance of olfactory receptor family 2 subfamily W member 3 (OR2W3) in gastric adenocarcinoma,and to explore its correlation with cell proliferation and apoptosis. Methods From January 2013 to June 2014, 61 patients with gastric adenocarcinoma diagnosed in the Affiliated Hospital of North China University of Technology and undergoing radical operation were selected as the study subjects. Neoplasm tissue were selected as the observation group, normal gastric mucosa ( 61 cases) were selected as the control group. Immunohistochemistry was used to detect the expression of or2w3 and HER-2 in the two groups. Fish was used to detect the amplification of HER-2 gene in some of the patients with uncertain expression of HER-2. Western blot was used to detect the expression of PCNA and BAX in the observation group. Results Positive rate of OR2W3 was higher in the observation group ( 50. 8%, 31／61) than that in the control group ( 8. 2%( 5／61 )), and the difference between the two groups was statistically significant(χ2＝26. 63,P＜0. 05). The difference of the positive rate of OR2W3 in the maximum diameter(≥6 cm was 68. 8%(22／32),＜6 cm was 31. 0%( 9／29)),depth of invasion(seroas and beyond was 63. 4%(26／41),less serosa was 25. 0%(5／20)),vascular and lymphatic vessel involvement ( involvement was 78. 6%( 11／14),no involvement was 42. 6%( 20／47)), lymph node metastasis(metastasis was 82. 1%(23／28),no metastasis was 24. 2%(3／33)) and TNM staging(Ⅲ+Ⅳwas 78. 1%(25／32),Ⅰ+Ⅱ was 20. 7%( 6／29)) in observation group was statistically significant ( χ2 was 8. 423,7. 937,5. 559,20. 318,20. 080,respectively,all P＜0. 05). Expression of OR2W3 was correlated with survival time(X2＝5. 31,P＜0. 05). Positive correlation was found between OR2W3 and PCNA expression(r＝0. 54,P＜0. 05) . Negative correlation were found between OR2W3 and BAX expression ( r＝－0. 59, P＜0. 05). There were 8 cases of HER-2 positive and 53 cases of HER-2 negative. The difference of OR2W3 expression in tumors with different HER-2 expression was statistically significant ( χ2＝4. 957,P＜0. 05) . Conclusion The expression of OR2W3 in gastric adenocarcinoma tissue is significantly increased,which can promote the proliferation of cancer cells and inhibit apoptosis. OR2W3 is related to HER-2 expression. Detection of OR2W3 expression may be of some value in judging prognosis.

Objective:To observe and analyze the application effect and value of problem based learning (PBL) combined with team-based learning(TBL) in the teaching of New Drug Clinical Research. Methods:Postgraduate students were randomly divided in-to two groups(n=20):"PBL+ TBL" group and lecture based learning(LBL) group. After the end of the teaching,the teaching ef-fectiveness survey and theory test of the groups were performed,and the results were compared. Results:The combined teaching meth-od (PBL+TBL) could stimulate learning enthusiasm, improve learning efficiency, and enhance the abilities of self-study, literature retrieval and analyzing and solving problems. Totally 90% of students thought the new teaching method had good application value in clinical teaching. Furthermore,the excellent rate of the theory test scores in the combined teaching group was better than that in the traditional teaching group (P<0.05). Conclusion: PBL combined with TBL can overcome the disadvantages of traditional teaching method,which provides higher interest,improved ability of self-study as well as higher teaching quality of medical students. The meth-od is worthy of promotion in postgraduate teaching.

Molecular docking is one of the main methods for computer-aided drug design (CADD). In recent years, molecular doc-king is widely used and has made some progress in the screening of pharmacodynamic substance, the target of finding drugs for diseases, and the mechanism exploration for traditional Chinese medicine. In this review, the principle and mechanism of molecular docking, and some commonly used software were introduced. And the application of molecular docking technology was summarized in the studies on the screening and pharmacodynamic mechanisms of traditional Chinese medicine. Finally, the existing problems were discussed, and the fu-ture trend in this field was looked ahead. The study can provide more scientific basis for the clinical research and development of new drugs.

Objective To understand the mutation characteristics of drug resistance-associated genes rpoB, katG and inhA in Mycobacterium tuberculosis (MTB) strains using gene chip method, and evaluate its clinical application value. Methods A total of 76 MTB strains were collected from Shijiazhuang area in 2013 to 2014. Gene chip was used to detect the mutations of rpoB, katG and inhA, and the L-J proportion drug susceptibility test was used as the gold standard to evaluate the overall concordance, sensitivity and specificity of gene chip. The consistency of microarray and phenotypic resistance was evaluated by Kappa test. Results Of all the 76 strains detected, 69 harbored mutations in katG/inhA. The predominant mutation site of katG was 315 codon with the mutation rate of 89.9%(62/69), and 5.8%(4/69) carried mutations at inhA-15(C→T), and 4.3%(3/69)carried combined mutations of katG 315 and inhA-15. The rpoB mutations were detected in 73 strains, of which 64.4%(47/73)carried mutations at codon 531, 15.1%(11/73)at codon 526, 12.3%(9/73)at 516 codon, 1.4%(1/73)at 513 codon, 1.4%(1/73)at 533 codon and 5.5%(4/73)had combined mutations. Compared with results from the L-J proportion method, the sensitivity, specificity and concordance rates of gene chip for RFP were 96.1%(73/76), 100%(50/50)and 97.6%(123/126). The sensitivity, specificity and concordance rates of gene chip for INH were 90.8%(69/76), 100%(50/50)and 94.4%(119/126). The sensitivity, specificity and concordance rates of gene chip for MDR-TB were 86.8%(66/76), 100%(50/50) and 92.1%(116/126). Conclusion The predominant mutation loci of MDR strains in Shijiazhuang area are katG315 and rpoB531. Gene chip is a fast and useful tool for clinical diagnosis of MDR strains.

Objective To investigate the changes of Treg cells,Th17 cells and related cytokines in pe?ripheral blood of patients with severe hand?foot?mouth disease( HFMD) in the initial stage of infection caused by Enterovirus 71 virus. Methods Thirty?five cases of severe HFMD children in the Fifth Hospital of Shijiazhuang from May 2013 to December 2013 were selected as the research subjects,including 27 cases of severe formed group and 8 cases of danger severe formed group. The frequencies of Th17 cells ( CD3+CD8?IL?17+) and Treg cells( CD4+CD25+Foxp3+) in peripheral blood were detected by flow cytometry in patients with severe HFMD and 31 healthy children(control group). Moreover the serum levels of interleukin 6(IL?6),interleukin 17(IL?17) ,interleukin 10( IL?10) ,interleukin 23( IL?23) ,and human transforming growth factorβ1 ( TGF?β1) were measured by ELISA. Results As compared with those in control group,the frequencies of Treg cells,ratio of Treg/Th17,serum levels of TGF?β1, IL?10 in severe HFMD groups were significantly decreased ( F=23. 23, 30. 88,10. 766,11. 680 respectively;P<0. 05) . However the frequency of Th17 cells,serum levels of IL?6,IL?17,IL?23 in severe HFMD groups were significantly increased( F=646. 81,5. 904,10. 557,3. 490 respectively;P<0. 05) . Conclusion The changes of Treg and Thl7 cells and related cytokines appear in peripheral blood of patients with HFMD in the initial stage of infection caused by Enterovirus 71 virus. The frequency of Treg cell is decreased,however,the frequency of Thl7 cells frequency is increased,as a result,which may spread inflammato?ry reaction and cause complication.