Objective To investigate the clinical characteristics and prognosis of primary testicular diffuse large B-cell lymphoma(PT-DLBCL).Methods The clinical data,treatment regimen and prognosis of PT-DLBCL patients were analyzed retrospectively,from the records of the Affiliated Hospital of Nantong University and the Second Affiliated Hospital of Dalian Medical University from Jan.1,2000 to Dec.31,2022.Results The median age of the 47 PT-DLBCL patients was 64 years old.The median overall survival(OS)was 41.6 months,with 1-year,3-year,and 5-year PT-DLBCL OS of 93%,77%,and 59%,respectively.Kaplan-Meier univariate analysis demonstrated that a diagnosed age≥70 years,Eastern cooperative oncology group(ECOG)score≥3,international prognostic index(IPI)score≥4,no combination of anthracycline and rituximab,a single treatment regimen,ineffective initial treatment and relapse,were asso-ciated with an adverse prognosis in PT-DLBCL(all P<0.05).Multivariate Cox regression analysis showed that an ECOG score≥3,no application of Rituximab,and an ineffective initial treatment response were independent risk factors for the poor prognosis of PT-DLBCL(all P<0.05).Conclusion PT-DLBCL is rare and associated with a poor prognosis.Early diagnosis and therapy with a combination of anthracyclines and rituximab may improve outcomes.

Objective · To evaluate the efficacy and safety of prophylactic phenylephrine in parturients prone to develop spinal hypotension.Methods · Fifty parturients undergoing elective cesarean delivery whose preoperative positional mean arterial pressure (MAP) change from supine to right lateral position were bigger than 8 mmHg (1 mmHg=0.133 kPa) were randomly allocated into 2 groups, i.e. high-risk prevented group (group A) and high-risk control group (group B). Another 25 parturients whose positional MAP change were smaller than 8 mmHg were allocated into low-risk prevented group (group C). After spinal anesthesia, phenylephrine (50 μg bolus and 50 μg/min infusion) was given immediately to group A and C, and the pump speed was adjusted to 25 μg/min 10 min later till fetuses were removed. Normal saline with the same volume and pump speed was given to group B. The incidences of hypotension, reactive hypertension, and bradycardia, the occurrence of nausea and vomiting, and Apgar scores at 1 min and 5 min of three groups were compared. Results · The incidence of hypotension in group A was 28%, 76% in group B, and 16% in group C. Group A and C were significantly lower than group B (P<0.01). The reactive hypertension rate was 4% in group A and 28% in group C. There was a difference between these two group (P=0.015). There were no significant differences among 3 groups in Apgar scores at 1 min and 5 min (P>0.05). Conclusion · Prophylactic phenylephrine in the paturients prone to develop spinal hypotension reduces the incidence of spinal hypotension without obvious adverse effects on the paturients and neonates.

BACKGROUND:Chitin has been found to be a good biomaterial, but research on chitin carrying corneal epithelial cel s for rabbit corneal epithelial injury is little reported. OBJECTIVE:To investigate the repair outcomes of chitin hybrid membrane carrying corneal epithelial cel s in the rabbit corneal epithelial injury.METHODS:Eighteen New Zealand white rabbits were enrol ed and made into left corneal epithelial injury models, and then randomized into two groups and treated with chitin hybrid membrane carrying corneal epithelial cel s (experimental group) and chitin hybrid membrane (control group), respectively. The damage area, histological changes and ultrastructure of the cornea were observed at 1, 3, and 7 days after implantation. RESULTS AND CONCLUSION:Damage area of the cornea in the experimental group was significantly less than that in the control group at 1 and 3 days after implantation (P<0.05), and the cornea in both two groups healed wel at 7 days after implantation. At 7 days after implantation, in both two groups, the corneal epithelium with six layers adhered to the corneal stroma closely, which was repaired completely and regularly. Comparatively speaking, the cornea in the experimental group possessed smooth outer layer. Besides, in the experimental group, the hexagonal corneal epithelial cel s arranged closely with flat surface;while the hexagonal corneal epithelial cel s in the control group showed no smooth surface and gaps between cel s. These results indicate that chitin hybrid membrane carrying corneal epithelial cel s promotes the repair of rabbit corneal epithelial injury.

Objective To investigate the protective effect of rosiglitazone on the rats with high altitude pulmonary edema.Methods Thirty-six SD rats were randomly (random number) divided into 6 groups (n =6 each):control group (Control),hypobaric hypoxia model group (HH),rosiglitazone groups (RSG) which were administered with 3 different doses [RSG-L:5 mg/ (kg · d),RSG-M:10 mg/ (kg·d),RSG-H:20 mg/ (kg· d)],dexamethasone group [Dex,4 mg/ (kg· d)].Rats were injected intraperitoneally with different doses of rosiglitazone (RSG),dexamethasone (Dex) or vehicle (Control and HH) for 3 days before placed in simulated altitude of 6 000 m hypobaric hypoxia animal chamber where the temperature and pressure were constant.After 72 h in the chamber,each rat was anesthetized.The water content of lung was determined with wet/dry weight ratio.Bronchoalveolar lavage fluid was measured by bradford method.The contents of GSH was measured by micro-ezymed labeled method.The contents of MDA was measured by TBA method.The enzymatic activities of SOD was measured by WST-1 method.The changes of the TNF-α,IL-6 and IL-10 in serum were determined by ELISA.Light microscope was used to observe the pathological changes of lung tissue.Results Compared with Control group,the wet/dry weight ratio of lung (5.08 ± 0.24) and total protein content of BALF (351.06 ± 44.55) μg/mL increased significantly (P ＜ 0.01) in HH group.There were red blood cells in the alveolar and interstitium,pink fluid exudation in the alveolar,the alveolar septum enhancement,and a large number of inflammatory cell infiltration;the SOD activity (10.65 ± 0.94) U/mgprot and the content of GSH (1.63 ±0.20) μmol/gprot in lung tissue were significantly decreased (P ＜ 0.01),the contents of MDA (2.1 5 ± 0.18) nmol/mgprot increased significantly (P ＜ 0.01),TNF-o (56.92 ± 2.87) pg/mL and IL-6 (217.80 ±48.01) pg/mL levels in serum were significantly increased (P ＜0.01),and IL-10 (76.85 ± 16.72) pg/mL level decreased (P ＜ 0.05).Compared with the HH group,the wet/dry ratio of lung and total protein content of BALF in different doses of rosiglitazone group significantly decreased (P ＜ 0.01),the pathological changes of the lung tissue was significantly improved,SOD activity and the content of GSH in lung tissue was significantly increased (P ＜ 0.01),the content of MDA decreased (P ＜ 0.01),The levels of TNF-α and IL-6 in serum were significantly decreased (P ＜ 0.01),while the IL-10 level was significantly increased (P ＜ 0.01).Conclusion Rosiglitazone could protect the high altitude pulmonary edema by alleviating the oxidative stress and inflammatory response.

BACKGROUND: During the repair of thoracolumbar fracture, pedicle screw fixation is a commonly used treatment method. In the process of fixation, the different approaches can be used. OBJECTIVE: To compare effect and biocompatibility of pedicle screw by percutaneous approach, posterior median approach, and intervertebral space approach for thoracolumbar fracture. METHODS: 118 cases of thoracolumbar fracture were included after pedicle screw fixation. Al patients were divided into three groups according to the approach: posterior median approach group (38 cases), intervertebral space approach group (40 cases) and percutaneous approach group (40 cases). After 12 months of folow-up, perioperative conditions, pain score, vertebral height of anterior border, kyphosis correction effect, adverse events and biological compatibility were compared among three groups. RESULTS AND CONCLUSION:(1) Operation time, intraoperative bleeding and time in bed after surgery were shorter or less in the percutaneous approach and intervertebral space approach groups than in the posterior median approach group. Postoperative drainage was better in percutaneous approach and intervertebral space approach groups than in the posterior median approach group (alP < 0.05). Except drainage in the percutaneous approach and intervertebral space approach groups, no significant difference in other indicators was found. (2) Patients received imaging examination at different time points. The percentage of anterior vertebral height and kyphosis were significantly improved immediately after treatment and in final folow-up (alP < 0.05). No significant difference was detected before treatment, immediately after treatment and in final folow-up. (3) Visual Analogue score was identical before treatment. Visual analogue score was lower in the percutaneous approach and intervertebral space approach groups than in the posterior median approach group at 24 hours and 3 days after treatment and in final folow-up (alP < 0.05). No significant difference was detectable at 24 hours and 3 days after treatment and in final folow-up between the percutaneous approach and intervertebral space approach groups. (4) No rejection or wound non-healing was seen at 12 months after treatment. Some patients suffered from mild low back pain, which was improved by active symptomatic treatment. (5) These findings suggest that intervertebral space approach percutaneous approach obtained satisfactory outcomes compared with posterior median approach for treatment of thoracolumbar spine fractures, and good biocompatibility was found.

Objective To prepare the anti-TLR4 C-terminal domain monoclonal antibody and investigate its effect in treatment of sepsis.Methods TLR4 C-terminal polypeptide (amino acid sequence:368-579,named as TLR4-C) was obtained through prokaryotic expression and Sephacryl S-100 gel purification,and then was used to immunize female Balb/c mice (6-8 weeks old).After cell fusion,antibody screening and purification,monoclonal antibody specific for the C terminal of TLR4 was obtained.Specificity of monoclonal antibody was detected by Western blot and cell immunofluorescence.In vitro antibody activity test,NR8383 was cultured for 1 h with adding antibody (100 μg/ml) and then 12 h after adding lipopolysaccharide (LPS) (10 ng/ml),and level of tumor growth factor (TNF)-α in the culture medium was tested by ELISA.In vivo septic animal experiment,40 SD rats were assigned to control antibody group (n =20) and anti-TLR4 monoclonal antibody group (n =20) according to the random number table.Each group was rejected 50 mg/kg corresponding antibodies via caudal vein for 1 h,and then LPS (10 mg/kg) via intraperitoneal injection for 4 h.Blood samples from caudal vein of ten rats in each group were collect to test the serum level of TNF-α.The rest rats in each group were used to measure the animal survival rate within 72 h.Results Three highly specific anti-TLR4 monoclonal antibodies were obtained and could combined with TLR4-C and TLR4 holoprotein.In vitro cell activity study indicated only one monoclonal antibody could obviously inhibit the release of TNF-α.In vivo animal experiment showed serum TNF-α level in anti-TLR4-C antibody group was (1.54 ± 0.18) ng/ml,significantly lower than (0.51 ± 0.10) ng/ml in antibody control group (P ＜ 0.01).Animal survival rate in anti-TLR4-C antibody group was 70％,higher than 30％ in antibody control group (P ＜ 0.05).Conclusion Anti-TLR4-C monoclonal antibodies have great capacity to neutralize TLR4 and good protective effect on LPS-induced sepsis.

BACKGROUND:Chitosan nanoparticles-encapsuled sodium hyaluronate is an effective drug for the burned cornea. OBJECTIVE:To verify the effect of sodium hyaluronate/chitosan nanoparticles on the neovascularization in burned cornea. METHODS:Thirty Sprague-Dawley rats were randomly divided into three groups, and the model of burned cornea caused by base was established in the rats of model and experimental groups, fol owed by respectively treated with 10μL sodium hyaluronate/chitosan nanoparticle suspension and normal saline, once daily, for consecutive 4 weeks. Rats only given normal saline were used as controls. Four weeks later, the dynamic growth of newly formed blood vessels in the cornea was observed using silt lamp. The levels of tumor necrosis factor-αand interleukin-6 were detected by ELISA, histological changes of the cornea were observed by hematoxylin-eosin staining, and the mRNA expression levels of vascular endothelial growth factor and cyclooxygenase 2 were detected by real-time PCR. RESULTS AND CONCLUSION:Compared with the control group, the area of the newly formed blood vessel and the levels of tumor necrosis factor-α, vascular endothelial growth factor and cyclooxygenase 2 were significantly increased in the model group (P<0.05, P<0.01). In the experimental group, al above indicators were significantly lower than those in the model group (P<0.05). There were a large number of inflammatory cel s and neovascularization in the model group, but only few inflammatory cel s in the experimental group. These results show that sodium hyaluronate/chitosan nanoparticles can inhibit the neovascularization in the burned cornea.

Objective To investigate the mechanism of oxidative damage caused by lipopolysaccharide (LPS)induced sepsis in rat brain.Methods The rats were randomly divided into control group and model group (low LPS group and high LPS group).Twenty-four hours after the modeling,the rats were sacrificed before their brain tissue was taken out and prepared for the test.The changes in malondialdehyde (MDA),superoxide dismutase (SOD),glutathione peroxidase (GSH-Px),total antioxidant capacity (T-AOC),hydrogen peroxide (H2 O2 )and succinate dehydrogenase (SDH)were detected.The expression level of JNK and Nrf2 protein in brain tissue was detected by qRT-PCR and Western blotting. Results Compared with the control group,the MDA,SOD,GSH-px,T-AOC,H2O2 and SDH level increased significantly in the model group,and the difference in expressions of JNK and Nrf2 was statistically significant (P <0.05). Conclusion The LPS induced septic oxidative brain damage model in rats is successfully established,and the process may be regulated through the Nrf2 and JNK signal pathways.

In April 10, 2010, an earthquake measuring magnitude 7.1 shocked Yushu County,Qinghai province. For medical rescue, the National Earthquake Disaster Emergency Rescue Team was sent to Yushu right away. Rescue work in Yushu was faced with such difficulties as short preparative time, heavy workload, high exposure to various acute high altitude diseases (AHAD), and a number of other diseases frequently found on the cold plateau. To ensure the rescue work a success, the team took a series of measures including efficient preparative procedure, scientific and logical procedure in the emergency medical aid operations, reliable and effective handling of AHADs, along with sufficient self protection for team members.

Objective To analyze emergency medical treatment measures and the problems encountered during disaster relief in Chinese intemational rescue team (CIRT) , and to provide reference to improve the level of medical assistance. Method The data were based on the materials of the emergency medical rescue work in Haiti earthquake disaster by CIRT. The data were retrospectively analyzed. Results From January 13 , 2010 to January 27, 2010, CIRT provided medical service for more than 2500 wounded and sick persons, including 700 traumatic debridement, 150 operations, 12 the critical wounded. CIRT duged out 15 bodies. Conclusion Fast and prepara-tive job is the foundation to complete rescue mission with high-quality . The unique workflow ensure to complete the emergency medical rescue missions. Profession and multi-function is the basic quality for intemational rescue team members. Medical equipment regularization is needed.