Objective:To evaluate the clinical efficacy of rituximab injection combined with CHOP regimen (cyclophosphamide+doxorubicin+vincristine+prednisolone) in the treatment of diffuse large B-cell lymphoma (DLBCL).Methods:One hundred and twenty patients with DLBCL who treatment in the First Affiliated Hospital of Xinjiang Medical University from June 2019 to June 2022 were selected as the study object. They were randomly divided into the study group (60 cases) and the control group (60 cases). The control group was treated with CHOP regimen, and the study group was treated with rituximab injection on the basis of CHOP regimen. The clinical efficacy, inflammatory reaction, immune function and adverse reaction were evaluated after 6 courses of treatment.Results:After treatment, the total clinical effective rate in the study group was higher than that in the control group: 88.33%(53/60) vs. 70.00%(42/60), there was statistical difference ( χ2 = 6.11, P<0.05). Before treatment, the levels of serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the two groups had no significant differences ( P>0.05); after treatment, the levels of serum IL-6 and TNF-α were decreased, and the levels of serum IL-6 and TNF-α in the study group were lower than those in the control group: (223.56 ± 21.28) ng/L vs. (267.35 ± 25.36) ng/L, (9.34 ± 2.75) μg/L vs. (11.96 ± 3.83) μg/L, there were statistical differences ( P<0.05). Before treatment, the levels of serum immunoglobulin (Ig) A, IgM and IgG in the two groups had no significant differences ( P>0.05); after treatment, the levels of serum IgA, IgM and IgG were decreased, but the levels of serum IgA, IgM and IgG in the study group were higher than those in the control group: (1.83 ± 0.46) g/L vs. (1.34 ± 0.34) g/L, (1.15 ± 0.22) g/L vs. (0.83 ± 0.24) g/L, (10.67 ± 1.65) g/L vs. (8.02 ± 1.62) g/L, there were statistical differences ( P<0.05). After treatment, the incidence of thrombocytopenia, leucopenia, gastrointestinal reaction, bone marrow suppression and liver function injury in the study group were lower than those in the control group: 6.67%(4/60) vs. 20.00%(12/60), 15.00%(9/60) vs. 31.67%(19/60), 30.00%(18/60) vs. 58.33%(35/60), 5.00%(3/60) vs. 16.67%(10/60), 10.00%(6/60) vs. 25.00%(15/60), there were statistical differences ( χ2 = 4.62, 4.66, 9.77, 4.33, 4.88, P<0.05). Conclusions:The treatment effect of rituximab injection combined with CHOP regimen in DLBCL is significant, which can reduce the inflammatory reaction of the body, reduce the damage of immune function, and reduce the adverse reactions of chemotherapy.

Objective:To investigate effect of Gehua Jiecheng Decoction on IL-6/JAK2/STAT3 signaling pathway in colon tissue of ulcerative colitis with"inflammatory to cancer transformation"(UC-UCAC)mice of spleen deficiency and damp-heat type.Methods:Ten from 80 SPF C57BL/6 male mice were randomly selected as blank group and other 70 mice were selected as model group.After establishment of spleen deficient damp-heat model,mice were randomly divided into model group(1st,2nd and 3rd cycle),Gehua Jiecheng Decoction high,medium and low doses groups and mesalazine group,with 10 pieces per group.UC-UCAC transformation model was further established with azo methane oxide solution(AOM)/sodium glucan sulfate(DSS).Each group was treated with corresponding drugs for 4 weeks.General state of mice was observed.Score of disease activity index(DAI)was calculated.HE staining was used to observe colonic mucosa pathology of mice.EGFR,IL-6,JAK2,STAT3 and p-STAT3 proteins and genes expressions in mice colon tissues were detected by Western blot,IHC and RT-qPCR,respectively.Results:Compared with blank group,mice in model group(3rd cycle)were generally in a worse state,colon mucosal tissue was cancerous,DAI score,target proteins and genes expressions were significantly increased(P<0.01).Compared with model group(3rd cycle),general state of mice in all treatment groups were restored and colonic tissues pathology were improved to some extent.Target proteins and genes expressions in other treatment groups were significantly decreased except for Gehua Jiecheng Decoction low-dose group(P<0.01).Conclusion:Gehua Jiecheng Decoction may destroy tumor inflammatory microenvironment,repair damaged colonic mucosa tissue,delay inflamma-tion-cancer transformation process and prevent UCAC by inhibiting activation of IL-6/JAK2/STAT3 signaling pathway.

Objective:To analyze the correlation between cognitive impairment and cortical atrophy in elderly patients with asymptomatic carotid artery stenosis (ACAS).Methods:In this cross-sectional study, 40 consecutive elderly patients with ACAS treated in the Department of Neurology, Northern Jiangsu People′s Hospital from July 1, 2020 to June 30, 2021 (ACAS group), and 40 elderly healthy controls who accepted physical examination during the same period (control group) were included. Cognitive assessment was performed using the Mental State Examination Scale (MMSE) and the Montreal Cognitive Assessment Scale (MoCA), and brain magnetic resonance imaging scanning was performed in the ACAS group. The artificial intelligence technique was applied for brain lobe segmentation and cortical volume calculation. The χ2-test, independent sample t-test and Wilcoxon non-parametric test were used to analyze the difference of clinical data and cognitive scores between the two groups. In the ACAS group, the cortical volumes of the side with carotid stenosis was compared with that of the normal side, and Spearman′s correlation analysis was used to assess the correlation between cognitive scores and cortical atrophy. Results:Compared with the control group, the ACAS group got significantly lower scores of MMSE and MoCA, as well as lower scores of visuospatial executive function, attention and calculation, language function, abstraction ability and delayed recall [(25.60±2.49) vs (27.18±1.01), (22.05±3.59) vs (25.60±1.43), (2.73±1.04) vs (4.08±0.62), (4.53±0.93) vs (5.03±0.66), 2.00 (0.00) vs 3.00 (0.00), 1.00 (1.00) vs 2.00 (0.00), and (2.95±0.96) vs (3.35±0.62)] (all P<0.05). There was not significant differences in naming and orientation ability between the two groups (both P>0.05). The volume of cortical, temporal lobe, frontal lobe, parietal lobe and insular lobe on the side with carotid stenosis in the ACAS group were significantly smaller than those on the normal side [186.23 (177.97, 202.53) vs 194.67 (185.65, 204.82) cm 3, 54.74 (50.66, 56.95) vs 55.61 (51.24, 58.49) cm 3, 72.98 (70.76, 78.34) vs 75.27 (72.34, 80.66) cm 3, 53.66 (51.11, 57.86) vs 56.59 (52.80, 60.09) cm 3, 6.57 (6.35, 7.07) vs 6.72 (6.46, 7.34) cm 3] (all P<0.05). The MoCA score in the ACAS group was positively related to the cortical volume ratio of the two sides ( r=0.427, P<0.01). The attention ( r=0.353) and abstraction ( r=0.226) ability scores were positively correlated with the temporal lobe volume ratios of the two sides (both P<0.05). The visuospatial executive ( r=0.187) and language ( r=0.373) ability scores were positively correlated with frontal lobe volume ratios of the two sides (both P<0.05), and visuospatial executive ( r=0.386), naming ( r=0.344), language ( r=0.517), abstraction ( r=0.335) and delayed recall ( r=0.333) ability scores were positively correlated with parietal lobe volume ratios of the two sides (all P<0.05). Conclusion:In elderly patients with ACAS, the cognitive impairment and cortical atrophy on the sides with carotid stenosis are significant and a positive correlation is detected between them.

【Objective】 To determine the therapeutic efficacy of cladribine combined with BuCy conditioning regimen for childhood acute leukemia, and compare it with fludarabine. 【Methods】 The clinical data of 70 children with acute leukemias who underwent all-HSCT from August 2018 to June 2020 were collected. The data of pretreatment-related toxicity, hematopoietic reconstitution, graft-versus-host disease, virus infection, relapsed and survival between CLAG and FLAG group were statistically analyzed. 【Results】 EBV infection in CLAG group was significantly more than that in FLAG group(P<0.05). There was no significant difference in RRTs, hematopoietic reconstitution, GVHD occurrence, OS and relapsed between CLAG group and FLAG group(P>0.05). Multivariate analysis showed that there was no significant difference in the effect of conditioning regimen on relapsed and survival. Among other risk factors, types of diseases were significantly correlated with OS (P<0.05, HR: 0.088). Relapse was significantly correlated with bone marrow morphological remission before transplantation and the matching degree of donor and recipient HLA(P<0.05, HR: 34.678; P<0.05, HR: 0.024). 【Conclusion】 There was no significant difference in RRTs, hematopoietic reconstitution, GVHD occurrence, OS and relapsed between CLAG group and FLAG group. The overall efficacy of CLAG group was not inferior to FLAG group.

Objective    To study the diagnosis and treatment of aortopulmonary window (APW) associated with severe pulmonary hypertension. Methods    The clinical data of 23 patients with APW undergoing surgical treatment in The First Affiliated Hospital of Air Force Medical University from 2010 to 2018 were retrospectively reviewed. There were 9 male and 14 female patients. The age was 3-132 (4.63±2.14) months. The weight was 3.3-35.0 (17.3±3.6) kg. Results    Windows were situated in the proximal of semilunar valve (type Ⅰ) in 8 patients, and distal of the aorta (type Ⅱ) in 14 patients, from proximal to distal (type Ⅲ) in only 1 patient. Eleven patients were isolated APW, the others were combined with cardiac defects. The mean pulmonary artery pressure was 68.4±7.5 mm Hg. All patients underwent surgical correction under general anesthesia and hypothermia cardiopulmonary bypass. All patients were discharged uneventfully, with an average follow-up time of 4 years. The patients showed good outcomes and no residual shunt after surgery, and the pulmonary artery pressure decreased to normal. Conclusion    APW is an uncommon congenital cardiac anomaly. The clinical presentation is an excessive left-to-right shunt, and most patients present early in life. Development of pulmonary hypertension and pulmonary vascular resistance is usually rapid. Operative treatment is indicated as soon as the diagnosis is established, regardless of the patient’s age, and most patients after surgery have a good long-term outcome.

Objective To evaluate whether the thalamic paraventricular nucleus mediates orexiner-gic ( orexin ) neurons-induced promotion of emergence from general anesthesia by using the optogenetics method in mice. Methods Twenty healthy male Hcrt-cre mice, aged 8-10 weeks, weighing 20-25 g, were divided into 4 groups ( n=5 each) using a random number table method: retrograde labeled viruses channelrhodopsin group ( R group) , anterograde labeled viruses channelrhodopsin group ( A group) , retro-grade labeled viruses control group ( RC group ) , and anterograde labeled viruses control group ( AC group) . The optogenetics technique was used in each group. Anesthesia was induced and maintained through inhaling 1％ isoflurane and pure oxygen 1. 0 L∕min. Electroencephalogram was monitored througout the procedure with the PowerLab monitoring system. The burst suppression ratio ( BSR) was recorded at 1 min before light stimulation and during light stimulation. Results Compared with RC group or the baseline at 1 min before light stimulation, the BSR was significantly decreased during light stimulation in R group ( P<0. 05) . Compared with AC group or the baseline at 1 min before light stimulation, the BSR was signifi-cantly decreased during light stimulation in group A ( P<0. 05) . Conclusion Optogenetics technique ap-plication once again confirms that orexin neurons can promote emergence from general anesthesia through thalamic paraventricular nucleus in mice.

OBJECTIVE: To systematically evaluate therapeutic efficacy and safety of Compound muni ziqi granules in the adjuvant treatment of chloasma, and to provide evidence-based reference for clinical treatment. METHODS; Retrieved from Chinese Journal Full-text Database (CJFD), China Scientific Journal Database (CSJD), Wanfang database, Medline and Embase, randomized controlled trials (RCTs) about therapeutic efficacy (total response rate, cure rate, the decrease level of E2, FSH and LH in serum) and safety of Compound muni ziqi granules alone or combined with routine drug (trial group) vs. routine drug (control group) in the treatment of chloasma were collected. Meta-analysis was conducted by using Rev Man 5. 3 statistical software after data extraction of clinical studies meeting inclusion criteria and quality evaluation with Cochrane systematic evaluator manual 5. 1. 0. RESULTS: Totally 12 RCTs were enrolled, involving 1 100 patients. Results of Meta-analysis showed that total response rate [OR=2. 84, 95％CI(2. 20, 3. 67), P<0. 001], cure rate [OR=2. 11, 95％CI(1. 59, 2. 79),P<0. 001],decrease level of Ez [OR=-98. 64, 95％ CI (-110. 84, -86. 44), P <0. 001], decrease level of FSH [OR=-1. 85, 95％CI(-2. 58,-1. 11),P<0. 001] and decrease level of LH [OR= - 5. 85, 95％ CI (-6. 83, -4. 87), P<0. 001] in trial group were significantly better than control group, with statistical significance. In trial group, a few patients suffered from the increase of menstruation, the decrease of menstruation, temporary pigmentation and transient burnout; but all symptoms did not affect the treatment. CONCLUSIONS: Compound muni ziqi granules show definite clinical efficacy and good response rate in the adjuvant treatment of chloasma with mild ADR.

OBJECTIVETo evaluate the preliminary efficacy of video-assisted anal fistula treatment (VAAFT) for complex anal fistula.

METHODSClinical data of 11 consecutive patients with complex anal fistula undergoing VAAFT in our department from May to July 2015 were reviewed. VAAFT was performed to manage the fistula under endoscope without cutting or resection.

RESULTSVAAFT was successfully performed in all the 11 patients. The internal ostium was closed using mattress suture in 10 cases, and Endo-GIA stapler in 1 case. The mean operative time was (42.0±12.4) min, mean hospital stay was (4.1±1.5) d. Complication included bleeding and perianal infection in 1 case respectively. After 1 to 3.2 months follow-up, success rate was 72.7%(8/11), and no fecal incontinence was observed.

CONCLUSIONVideo-assisted anal fistula treatment is an effective, safe and minimally invasive surgical procedure for complex anal fistula with preservation of anal sphincter function.

Objective To detect the levels of IL-1, IL-6,TNF-αand IFN-γin serum and colon tissue of rat mod-els of ulcerative colitis with spleen and kidney Yang deficiency, and to explore their roles in the pathogenesis of ulcerative colitis ( UC) .Methods The rat model of ulcerative colitis with Yang deficiency of spleen and kidney was induced by perfusion of rhubarb decoction plus intramuscular injection of hydrocortisone and combined with TNBS (2,4,6-trinitro-benzenesulfonic acid) and ethanol enema.Sixty SPF wistar rats ( body weight 180 ±10 g, male:female=1:1) were ran-domly divided into blank control group, UC model with spleen kidney Yang deficiency for 7 days, 14 days and 21 days groups, respectively.The levels of IL-1, IL-6, TNF-αand IFN-γin serum and colon tissue were detected by ELISA.Re-sults Compared with the blank group, the levels of IL-1, IL-6, TNF-αand IFN-γin serum and colon tissue of rat UC model group with spleen kidney Yang deficiency were greatly increased (P<0.05), especially evidently increased in the model group at 21 days.Conclusions The pro-inflammatory cytokines IL-1, IL-6, TNF-αand IFN-γplay an important role in the pathogenesis of ulcerative colitis with syndrome of spleen and kidney Yang deficiency.

Objective To investigate the effects of exposure to cigarette smoke on the counts and functions of tolerogenic dendritic cells(tDC) and regulatory T cells(Treg) in a mouse model of asthma. Methods Forty female BALB/c mice at age 20 days were randomly allocated into four groups including the normal saline ( NS)/air treatment group, the NS/cigarette smoke ( CS) treatment group, the ovalbumin (OVA)/air treatment group and the OVA/CS treatment group (n=10).A mouse model of asthma was es-tablished by intraperitoneally injecting OVA in an interval of two weeks to cigarette smoke for three weeks. The percentages of Treg cells in PBMCs and the changes of CD80 and CD86 expression on the surface of DCs of the mice in each group were analyzed by flow cytometry analysis.The transcriptional levels of forkhead box P3 ( Foxp3) in lung tissues were measured by real-time quantitative PCR.The levels of IFN-γ, IL-4, IL-6, IL-10, IL-12p40, IL-17A and TGF-β1 in bronchoalveolar lavage fluid ( BALF) samples were measured by ELISA.Results Exposing young mice to cigarette smoke significantly increased the percentages of Treg cells in PBMCs and the expression of Foxp3 at mRNA level in lung tissues of mice with asthma.High levels of TGF-β1 and IL-10 were detected in BALF samples of the heathy mice and those with asthma exposed to CS at a young age.The mice with asthma exposed to CS at an early age showed decreased expression of CD80 and CD86 on the surface of DCs.Lower levels of IL-12p40 and IL-6 and higher levels of IFN-γ, IL-4 and IL-17A in BALF samples were observed in mice from the OVA/CS treatment group.Conclusion Expo-sing to cigarette smoke at an early age was involved in the dysfunction of T cell-mediated immune responses in mice with asthma.This study might provide new ideas for the prevention and treatment of asthma.