Objective: To analyze the clinical characteristics of children with Burkitt lymphoma (BL) and to summarize the mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 (CNCL-B-NHL-2017) regimen. Methods: Clinical features of 436 BL patients who were ≤18 years old and treated with the CNCL-B-NHL-2017 regimen from May 2017 to April 2021 were analyzed retrospectively. Clinical characteristics of patients at disease onset were analyzed and the therapeutic effects of patients with different clinical stages and risk groups were compared. Survival analysis was performed by Kaplan-Meier method, and Cox regression was used to identify the prognostic factors. Results: Among 436 patients, there were 368 (84.4%) males and 68 (15.6%) females, the age of disease onset was 6.0 (4.0, 9.0) years old. According to the St. Jude staging system, there were 4 patients (0.9%) with stage Ⅰ, 30 patients (6.9%) with stage Ⅱ, 217 patients (49.8%) with stage Ⅲ, and 185 patients (42.4%) with stage Ⅳ. All patients were stratified into following risk groups: group A (n=1, 0.2%), group B1 (n=46, 10.6%), group B2 (n=19, 4.4%), group C1 (n=285, 65.4%), group C2 (n=85, 19.5%). Sixty-three patients (14.4%) were treated with chemotherapy only and 373 patients (85.6%) were treated with chemotherapy combined with rituximab. Twenty-one patients (4.8%) suffered from progressive disease, 3 patients (0.7%) relapsed, and 13 patients (3.0%) died of treatment-related complications. The follow-up time of all patients was 24.0 (13.0, 35.0) months, the 2-year event free survival (EFS) rate of all patients was (90.9±1.4) %. The 2-year EFS rates of group A, B1, B2, C1 and C2 were 100.0%, 100.0%, (94.7±5.1) %, (90.7±1.7) % and (85.9±4.0) %, respectively. The 2-year EFS rates was higher in group A, B1, and B2 than those in group C1 (χ²=4.16, P=0.041) and group C2 (χ²=7.21, P=0.007). The 2-year EFS rates of the patients treated with chemotherapy alone and those treated with chemotherapy combined with rituximab were (79.3±5.1)% and (92.9±1.4)% (χ²=14.23, P<0.001) respectively. Multivariate analysis showed that stage Ⅳ (including leukemia stage), serum lactate dehydrogenase (LDH)>4-fold normal value, and with residual tumor in the mid-term evaluation were risk factors for poor prognosis (HR=1.38,1.23,8.52,95%CI 1.05-1.82,1.05-1.43,3.96-18.30). Conclusions: The CNCL-B-NHL-2017 regimen show significant effect in the treatment of pediatric BL. The combination of rituximab improve the efficacy further.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Burkitt Lymphoma/drug therapy* ; Child ; Disease-Free Survival ; Female ; Humans ; Lactate Dehydrogenases ; Lymphoma, B-Cell/drug therapy* ; Male ; Prognosis ; Retrospective Studies ; Rituximab/therapeutic use* ; Treatment Outcome

Child ; Humans ; COVID-19 ; SARS-CoV-2 ; COVID-19 Testing

Objective:To seed for stable time window of the integrated disease-syndrome animal model based on the counterevidence from Chinese medicinal prescriptions， and to verify syndrome stability and reliability. Method:A model of depression was established by exposing rats to chronic unpredictable mild stress （CUMS）， followed by body weight measurement， sugar water test， behavioral test， and brain 5-hydroxytryptamine（5-HT） detection. The identification of liver depression and spleen deficiency syndrome was conducted after the equivalent transformation of human clinical symptoms into macroscopic representations of rats. Based on the dynamically collected macroscopic representation scale， Xiaoyaosan was used to reversely verify the stability and reliability of the integrated disease-syndrome animal model of depression due to liver depression and spleen deficiency. Result:The sugar water consumption and the number of crossings and the total movement distance in the open field test of 16-week-old rats in the CUMS （eight weeks of CUMS） group were significantly lower than those in the normal group （P<0.05）. According to the immunohistochemical results， the 5-HT content in hippocampal area CA2 of rats in the CUMS group was also significantly lowered as compared with that in the normal group（P<0.05），which indicated that depression was successfully modeled. The liver depression and spleen deficiency syndrome was present in 14-week-old rats （six weeks after CUMS）of the CUMS group， and the number of rats experiencing the liver depression and spleen deficiency syndrome reached the peak in the 16th week （eight weeks after CUMS），accounting for 70% of the total number. Thereafter， the number decreased gradually. The syndrome scores of the 14-， 16-， 18-， 20-， and 22-week-old rats in the Xiaoyaosan group were reduced by 66.6%， 70.7%， 54.8%， 50.4%， and 44.8%， which were graded as effective， marked effective， effective， effective， and effective， respectively. Conclusion:The age of 14-16 weeks（six to eight weeks after CUMS） is considered the stable and reliable time window for depression due to liver depression and spleen deficiency.

【Objective】 To investigate the mechanism of atorvastatin improving ventricular remodeling in rats with myocardial infarction. 【Methods】 Ligation of left anterior descending coronary artery was performed to establish rat model of myocardial infarction. Thirty rats were divided into sham group(n=10), myocardial infarction group(n=10) and atorvastatin group(n=10). Echocardiography was used to examine cardiac function and left ventricular mass index(LVMI) was calculated. The content of arginine vasopressin(AVP) in left ventricular non-infarct area and serum was measured by ELISA. Masson staining was used to observed interstitial fibrosis of myocardium. Immunohistochemistry was used to measure the expression of type Ⅰ collagen. The protein expression of transforming growth factor-β1(TGF-β1) was detected by western blot. 【Results】 After 5 weeks, the number of rats in sham group, myocardial infarction group and atorvastatin group was 10, 9 and 10, respectively. Compared with sham group, LVEF was significantly decreased and, LVMI, interstitial fibrosis, the content of AVP, the expression of type Ⅰ collagen and TGF-β1 in the left ventricular non-infarct area were significantly increased in myocardial infarction group and atorvastatin group(P<0.05). Atorvastatin significantly increased LVEF and decreased interstitial fibrosis, the content of AVP, the expression of type Ⅰ collagen and TGF-β1 in the left ventricular non-infarct area(P<0.05) . 【Conclusion】 Atorvastatin could ameliorate ventricular remodeling in rats with myocardial infarction, which might be associated with inhibiting the expression of AVP and TGF-β1.

Objective To investigate interaction effect of hyperglycemia and hyperuricemia on the patients with abnormal alanine aminotransferase(ALT). Methods From March to November 2018, 5 223 cases with complete and suitable data were enrolled in the physical medical examination in Yichang, Hubei Province of China. The metabolic characteristics of the two groups (508 ALT anomaly cases and 513 normal cases) were compared and analysed, Logistic regression model was used to study the independent effects of risk factors, and the interaction between risk factors was analyzed by additive model and multiplicative model. Results Levels of uric acid, triglyceride, total cholesterol, low density lipoprotein-cholesterol, fasting blood glucose, systolic blood pressure, diastolic blood pressure, body mass index, aspartate aminotransferase were significantly higher than that of the control group(all P<0.05). After adjusting some confounding factors, multivariate Logistic regression analysis showed that risk of abnormal ALT was 5.62 times higher in subjects with hyperglycemia and hyperuricemia than in subjects without them(95% CI:1.65-19.73, P=0.004). Interaction analysis of risk factors for abnormal ALT showed that there was no multiplicative interaction between hyperglycemia and hyperuricemia, but with additive interaction, the synergy index was 3.02, the relative excess risk due to interaction was 3.09, the attributable proportion due to interaction was 54.98% and pure factor attribution interaction was 66.87%. Conclusions There are several abnormal metabolic indices in individuals with abnormal ALT. The positive interaction between hyperglycemia and hyperuricemia are among the important risk factors for abnormal ALT patients. They can significantly increase the risk of illness.

Diabetic cognitive dysfunction (DCD) is a common chronic complication of diabetes mellitus with sophisticated path-ogenesis which has not yet been fully elucidated. In this review paper, the mechanisms of metabolic abnormalities, insulin re-sistance,endoplasmic reticulum stress,neuronal calcium dysho-meostasis, in ammation, blood brain barrier impairment, and mitochondrial injury associated with DCD are reviewed. In addi-tion,the prevention and treatment of DCD by traditional Chinese medicines (TCMs) and the effective compounds are comprehen-sively summarized, in order to provide an updated overview on the DCD pathogenesis,as well as the scientific evidence under-pinning the use of TCM interventions for the treatment and pre-vention of DCD.

OBJECTIVETo investigate the effect of metformin on 3T3-L1 preadipocyte's differentiation and consequently observe the anti-proliferative effects of metformin-treated adipocytes on leukemia cells.

METHODSDifferent concentrations of metformin were added in 3T3-L1 preadipocytes to induce maturation, the matured adipocytes were detected by oil red O staining and quantified by absorbance value (OD). Real-time PCR was used to detect the mRNA expression level of the key adipogenic genes PPARγ, C/EBPα and FABP4(ap2). The adipocytes were co-cultured with GFP+-THP-1 cells, 1 µg/ml of cytarabine(Ara-C) was added and incubated for 48 hours, the flow cytometry was used to detect the apoptosis rate of GFP+-THP-1 cells. Adipocyte supernatant was collected and mixed with equal volume of tumor lysat medium (RPMI 1640) at 1:1 to culture tumor cells. The leukemia cell proliferation activity was detected by CCK-8; after 48 hours of adding 1 µg/ml Ara-C, the protective effect on chemotherapy was assayed by using cytometer.

RESULTSThe metformin lowered the OD value, and the expression levels of both adipogenic genes C/EBPα and FABP4 were lower than those of controls, while the expression level of PPARγ mRNA was not significantly changed, the apoptosis rate of leukemia cells co-caltured with metformin-treated adipocytes was higher than that of co-cultured cells without metformin treatment. The adipocytes promoted the leukimia cell proliferation and protected leukemia cells from chemotherapy, which could be abrogated by metformin.

CONCLUSIONThe metformin can inhibit the differentiation of 3T3-L1 preadipocytes into adipocytes, and can regulate the protective effect of adipocytes on the apoptosis, proliferation and chemotherapy of leukemia cells.

3T3-L1 Cells ; Adipocytes ; Adipogenesis ; Animals ; CCAAT-Enhancer-Binding Protein-alpha ; Cell Differentiation ; Cell Proliferation ; Cytarabine ; Drug Resistance, Neoplasm ; Fatty Acid-Binding Proteins ; Humans ; Leukemia ; Metformin ; Mice ; PPAR gamma ; RNA, Messenger

OBJECTIVETo compare the adipogenesis and the adipocyte function between 3T3-L1 cells and human bone marrow mesenchymal stem cells (MSCs) in vitro.

METHODSBy density gradient centrifugation and adherent culture, the MSCs were isolated from human bone marrow and purified. The cell morphology was observed under an inverted microscope. After the induction of adipogenic differentiation, the differentiation level was detected by oil red O staining and OD values. The expression of PPARγ, FABP4 and C/EBPα mRNA was detected by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). Adipocytes and THP-1 cells were co-cultured by adding 1 µg/ml cytarabine. The ability of chemotherapy resistance was measured after 48 h.

RESULTSThe Oil Red O staining and measuring the absorbance showed that the lipid content in 3T3-L1 cells group was more than that in MSCs group, and the OD value was higher than that in MSCs group (P < 0.05). The results of qRT-PCR showed that the relative expression of PPARγ, FABP4 and C/EBPα mRNA of 3T3-L1-derived adipocytes was higher than that of human bone marrow MSCs-derived adipocytes (P < 0.05). Coculture experiments showed that the number of viable THP-1 cells in the group containing adipocytes was more than that in the control group (P < 0.05). The difference between 3T3-L1 cell group and MSC group was statistically significant (P < 0.05).

CONCLUSIONThe ability of adipogenesis of 3T3-L1 cells is higher than that of human bone marrow MSCs in vitro. Adipocytes can protect THP-1 cell line against cytarabine, and the effect of adipocytes from 3T3-L1 cell group is greater than that from the human bone marrow MSC group.

3T3-L1 Cells ; Adipocytes ; Adipogenesis ; Animals ; Bone Marrow Cells ; CCAAT-Enhancer-Binding Protein-alpha ; Cell Differentiation ; Fatty Acid-Binding Proteins ; Hematopoietic Stem Cells ; Humans ; Mesenchymal Stromal Cells ; Mice ; PPAR gamma ; RNA, Messenger

The genesis and development of leukemia not only associate to intrinsic factors, but also relate with the fibrous hyperplasia in the bone marrow. This review mainly focuses on the interaction between fiber-producing cells and leukemia cells, the relationship between fibrous hyperplasia and prognosis of leukemia, the regulation of TGF-beta, PDGF and other cytokines, the underlying mechanism of fibrous hyperplasia so as to explore the potential therapeutic targets for improving the prognosis of leukemia.
Bone Marrow ; pathology ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cytokines ; metabolism ; Fibroblasts ; cytology ; Humans ; Leukemia ; pathology ; Platelet-Derived Growth Factor ; metabolism ; Transforming Growth Factor beta ; metabolism

This study was purposed to elucidate the prognostic values of ALIP (abnormal location of immature precursors)-like clusters and fibrous proliferation in bone marrow of AML patients in CR phase and the correlation between them. The bone marrow biopsy sections from 47 AML patients during admitting to relapse or till lost follow-up were examined retrospectively. The 47 patients were divided into pre-relapsed group and non-relapsed group according to relapse or not at end of follow-up. The concentration of ALIP-like cluster and reticulin fiber density (RFD) in sections were compared between the two groups respectively, the prognostic value of these two factors and the underlying relationship between them were estimated by statistical analysis. The results showed that ALIP-like cluster was (3.46 ± 2.71)/mm(2) during CR and RFD was (2.76% ± 1.50%) in pre-relapsed cases, which both were higher than those in non-relapsed cases (P < 0.05). Cases with ALIP-like cluster over 4/mm(2) or with RFD>1.68% showed high relapse rates of 89.5% or 95.2% respectively. RFD were (2.47% ± 2.48%) and (2.44% ± 2.23%) in cases with >4/mm(2) or ≤ 4/mm(2) respectively, there was no statistical significance (P > 0.05) . Meanwhile, the amount of ALIP-like cluster in CR not related with the paired RFD (r = 0.057, P > 0.05). It is concluded that both ALIP-like cluster in CR and RFD are poor prognostic factors for heralding early relapse. However, ALIP-like cluster and RFD show no correlation, and suggest that forming of ALIP not depends on fibrogenesis.
Adolescent ; Adult ; Aged ; Bone Marrow ; pathology ; Female ; Humans ; Hyperplasia ; Leukemia, Myeloid, Acute ; pathology ; Male ; Middle Aged ; Young Adult