Objective: To evaluate the efficacy of the Hodgkin lymphoma (HL)-2013 regimen in the treatment of children with HL, and to investigate the prognostic factors of childhood HL. Methods: Clinical data of 145 children (aged ≤18 years) with newly diagnosed HL, treated with HL-2013 regimen in 8 tertiary referral centers for childhood cancer from August 2011 to April 2021 were analyzed retrospectively. All the diagnosis were confirmed by histopathological morphology and immunohistochemical examination. The clinical characteristics and treatment outcomes were summarized, and the patients were divided into different groups according to clinical characteristics. Kaplan-Meier method was used for survival analysis, and the comparison of survival rates between groups was performed with Log-rank test. Results: Of the 145 cases, there were 115 males and 30 females, the age at diagnosis was 7.9 (5.8, 10.6) years. Cervical lymph node enlargement (114 cases, 78.6%) was the common symptom of the disease, and 57 patients (39.3%) were accompanied by large masses. The most common pathological classification was mixed cell type (93 cases, 64.1%). According to the Ann Arbor staging system, there were 9 cases of stage Ⅰ, 62 cases of stage Ⅱ, 45 cases of stage Ⅲ, 29 cases of stage Ⅳ. According to the risk stratification: there were 14 cases of low-risk group, 76 cases of medium-risk group and 55 cases of high-risk group. Of all patients, 68 cases (46.9%) achieved an early complete remission (CR) after 2 courses of chemotherapy, and the CR rate was 93.8% (136/145) after first-line treatment. Disease recurrence or progression occurred in 22 cases (15.2%). Of all patients, 125 cases survived, 6 cases died and 14 cases were lost to follow-up. Among the survived cases, 123 cases were continuously at CR state,and the follow-up time was 55 (40, 76) months. The 5-year overall survival (OS) and event free survival (EFS) rates were (95.3±1.9)% and (84.2±3.0)% for the entire group, respectively. 5-year OS and EFS rates for patients with stage Ⅲ-Ⅳ were both lower than those for patients with stage Ⅰ-Ⅱ (χ²=6.28 and 7.58, both P<0.05), the 5-year OS and EFS rates for patients in high-risk group were both lower than those for patients in low-risk and medium-risk group (χ²=10.93, 7.79, both P<0.05). The 5-year OS rates for the patient with early CR and without early CR were 100.0% and (90.9±3.6)% (χ²=5.77, P=0.016). EFS rates for the patient with early CR (68 cases) and without early CR (77 cases) were (93.8±3.0)% and (75.8±5.0)% (χ²=8.78, P=0.003). Conclusions: HL-2013 regimen is significantly effective in the treatment of pediatric HL. However, the patients in high-risk group and those without early CR are prone to disease recurrence or progression. Stage Ⅲ-Ⅳ and without early CR were associated with worse prognosis.
Child ; Female ; Male ; Humans ; Hodgkin Disease ; Retrospective Studies ; Neoplasm Recurrence, Local ; China ; Antineoplastic Combined Chemotherapy Protocols ; Prognosis ; Disease-Free Survival

ObjectiveDuring the prevention and control of COVID-19, it is a difficult problem to obtain the individual epidemiological status of outpatients efficiently and accurately in a large comprehensive third-grade class-A hospital. To discuss the application and effect of WeChat applet and integrity propaganda and education in outpatient pre-examination during the prevention and control of COVID-19.MethodsFirstly, the outpatients were treated with integrity propaganda and education (like informing the law and regulations, recording the personal credit) at the outpatient pre-examination office. Secondly, let them take real-name authentication in the hospital self-developed WeChat applet. Thirdly, the outpatients filled in the epidemiological questionnaire related to COVID-19 by WeChat. The differences between before using the application (8,186 patients) and after using (7,361 patients) were compared in pre-examination time and concealing the incidence of an individual's epidemiological history.ResultsAfter the application of WeChat applet and integrity propaganda and education, the pre-examination time after using application [(1.07±0.23)min] was shorter than that before using[(2.15±0.37) min] (P<0.05). The concealment rate of epidemiological history was 0.05% before using application and zero after using.ConclusionWeChat applet and integrity propaganda and education can shorten the pre-examination time of covid-19 and reduce the occurrence of concealing personal epidemiological history.

To preliminarily analyze the prevention and control of COVID-19, a general hospital outpatient service took six management measures, including setting up a leading group, building rules and regulations, infection control and supervision, special training, humanized service, public opinion propaganda. After nearly two months, the rates of both body temperature monitoring and epidemiological history screening are 100%, the medical staff infection rate is zero, and no cross infection between the patients due to adopting outpatient service comprehensive management measures which had strong organization and leadership, effective targeted training, effective control of all links in epidemic prevention and control work. During the fight against COVID-19, outpatient management played an important role in hospital management. The above approaches provide valuable experience for preventing the spread of infectious diseases effectively and winning the biological weapon wars in the future.

Ischemic stroke is one of the leading causes of death worldwide. In the post-stroke stage, cardiac dysfunction is common and is known as the brain-heart interaction. Diabetes mellitus worsens the post-stroke outcome. Stroke-induced systemic inflammation is the major causative factor for the sequential complications, but the mechanism underlying the brain-heart interaction in diabetes has not been clarified. The NLRP3 (NLR pyrin domain-containing 3) inflammasome, an important component of the inflammation after stroke, is mainly activated in M1-polarized macrophages. In this study, we found that the cardiac dysfunction induced by ischemic stroke is more severe in a mouse model of type 2 diabetes. Meanwhile, M1-polarized macrophage infiltration and NLRP3 inflammasome activation increased in the cardiac ventricle after diabetic stroke. Importantly, the NLRP3 inflammasome inhibitor CY-09 restored cardiac function, indicating that the M1-polarized macrophage-NLRP3 inflammasome activation is a pathway underlying the brain-heart interaction after diabetic stroke.

Objective :To explore plasma expression levels of human maternal expression gene 3 (MEG3) and urotheli-al carcinoma antigen 1 (UCA1) in patients with acute myocardial infarction (AMI) and their clinical significance . Methods : A total of 90 AMI patients treated in our hospital were enrolled as AMI group ,and 50 healthy subjects un-dergoing physical examination in our hospital simultaneously were treated as healthy control group .Plasma expres-sions of MEG3 and UCA1 ,serum levels of creatine kinase isoenzyme MB (CK-MB) and cardiac troponin I (cTnI) were observed and compared between healthy control group and AMI group on 1h ,3h ,6h and 12h after onset . Spearman correlation analysis was used to analyze their correlation .Results : Compared with healthy control group , there was significant rise in plasma MEG3 expression [ (0-002 ± 0-001) vs .0-017 ± 0-003)] ,and significant reduc-tion in UCA1 expression [ (0-027 ± 0-005) vs .(0-017 ± 0-002)] in AMI group on 1h after onset , P＝0-001 both ;after 3h ,there were significant rise in serum levels of CK-MB [ (20-01 ± 3-05) IU／L vs.( (32-10 ± 4-40) IU／L] and cTnI [ (1-01 ± 0-87) ng／L vs.(2-10 ± 0-91) ng／L] in AMI group , P＝0-001 all.Spearman correlation analy-sis indicated that in plasma MEG3 expression was significant positively correlated with serum CK-MB and cTnI levels ( r＝0-351 ,0-368 , P＜0-05 both) ,and plasma UCA1 expression was significant inversely correlated with serum levels of CK-MB and cTnI (r＝ －0-416 ,－0-425 , P＜0-01 both) AMI patients .Conclusion : Plasma MEG3 level significant rises ,and UCA1 level significantly reduces in AMI patients during early onset period .Both are signifi-cantly correlated with CK-MB and cTnI levels ,which may be used as new markers diagnosing early AMI .

Objective Single mechanical ventilation for curing severe acute respiratory distress syndrome (ARDS) is sometimes not effective in improving oxygenation and removing excess CO₂ in the blood. The purpose of this study is to observe the effect of continuous renal replacement therapy（CRRT）combined with low-flow extracorporeal membrane oxygenation （ECMO）of V-V mode on clearance of inflammatory mediators，improving oxygenation and reducing PaCO₂ in canines with ARDS and hypercapnia. Methods 30 healthy adult canines were divided into 3 groups (n=10 each) using a random number table method sham group, ECMO (EC) group and CRRT+ECMO（CR+EC）group. A canine model of ARDS with hypercapnia were prepared by injected intravenously oleic acid. Sham group was only treated with invasive mechanical ventilation. EC group was treated with invasive mechanical ventilation and ECMO. CR+EC group was treated with CRRT combined with low-flow ECMO of V-V mode besides invasive mechanical ventilation. The heart rate(HR)，mean artery pressure (MAP)，cardiac output(CO) and concentration of serum TNF-α and IL-6 were examined at the beginning of modeling(T₀)，after 1，3，6 and 9 (T₁, T₃, T₆, T₉) hours of mechanical treatment respectively. Oxygenation index（OI），PaCO₂, temperature（T）were examined at the beginning of modeling，after 3, 6, 9 hours of mechanical treatment，and at the time point of 3 hours(T12) after ECMO treatment (EC group) and CRRT+ECMO treatment(CR+EC group)，respectively. The differences were compared between groups involved in above-mentioned indexes at different time points. Results Compared with the sham group, the HR decreased at T₆ and T₉ in the EC group and CR+EC group (P<0.05), and the concentration of IL-6 and TNF-α decreased at T₃, T₆ and T₉ in the CR+EC group (P<0.05). Compared with T₀, HR decreased at T₆ and T₉ in the EC group (P<0.05). Compared with T₀, the concentration of IL-6 and TNF-α decreased at T₃, T₆ and T₉ in the CR+EC group (P<0.05). Compared with the EC group, the HR decreased at T₆ and T₉ in the CR+EC group (P<0.05). Compared with the EC group, the concentration of IL-6 and TNF-α decreased at T₃, T₆ and T₉ in the CR+EC group (P<0.05). Compared with the sham group, the OI decreased at T₉ and T₁₂ in the CR+EC group (P<0.05). Compared with the sham group, PaCO₂ decreased at T₃, T₆ and T₉ in the EC group and CR+EC group (P<0.05). Compared with the EC group, the OI decreased at T₉ and T₁₂ in the CR+EC group (P<0.05). Compared with T₀, the OI decreased at T₆ and T₁₂ in the CR+EC group (P<0.05). Conclusion The CRRT combined with low-flow ECMO of V-V mode has positive effects on clearance of inflammatory mediators，reducing hypercapnia and improving oxygenation in the canines with ARDS and hypercapnia.

Objective:To detect the colony number of bacteria, yeasts and molds in fermentation process of Pinelliae Rhizoma Fermentata (PRF), microbial flora species, and quantitatively analyze the dynamic changes of four dominant microorganisms at different fermentation time points of PRF, so as to provide experimental basis for exploring the processing mechanism of PRF. Method:According to Pharmaceutical Standard Preparation of Traditional Chinese Medicine Prescription of Ministry of Health of the People's Republic of China (the 10^th volume), PRF was processed. The samples at five different fermentation time points (0, 30, 60, 90, 120 h) of PRF were taken, the culturing, isolation and purification of bacteria, yeasts and molds were carried out with selective media, and the colonies were counted. Fluorescence quantitative polymerase chain reaction (PCR) technique was employed to conduct absolute quantification of Bacillus subtilis, Paecilomyces variotii, Byssochlamys spectabilis and Aspergillus niger. The recombinant plasmids of these 4 microorganisms were used as the standard substances, and the standard curves were prepared after dilution of multiple ratios, quantitative analysis was performed on these 4 microorganisms in five samples at different processing time points (0, 30, 60, 90, 120 h) of PRF. Result:During the fermentation process of PRF, the number of bacteria was low with smooth change, while molds and yeasts grew dramatically at the late stage of fermentation and reached 1×10⁶ CFU·mL^-1 at the end of fermentation. At 5 different fermentation time points, the copy numbers of Bacillus subtilis were 3.53×10⁵, 7.56×10⁴, 1.58×10⁵, 1.90×10⁶, 1.85×10⁶ copies·g^-1, the copy numbers of Paecilomyces variotii were 0, 0, 0, 3.45×10⁷, 4.15×10⁸ copies·g^-1, the copy numbers of Byssochlamys spectabilis were 0, 0, 0, 1.04×10⁸, 2.28×10⁸ copies·g^-1, the copy numbers of Aspergillus niger were 0, 0, 9.48×10⁵, 1.47×10⁶, 7.56×10⁶ copies·g^-1, respectively. Conclusion:The change trend of microflora in the fermentation process of PRF can be reflected by the dynamic change of four dominant microorganisms, and molds may play an important role in the processing of PRF. Fluorescence quantitative PCR technique has the advantages of rapidity, sensitivity, good repeatability and high specificity, it is suitable for exploring processing mechanism of PRF.

A high-content GABA was found in Sojae Semen Praeparatum(SSP), which is a famous traditional Chinese medicine and officially listed in Chinese Pharmacopoeia. To screen out and identify GABA-producing microbes from samples at different time points during the fermenting process of SSP, traditional microbiological methods combined with molecular biological methods were used to study the predominant GABA-producing microorganisms existing in the fermenting process of SSP. This study would lay a foundation for further studying the processing mechanism of SSP. The fermenting process of SSP was based on Chinese Pharmacopoeia(2010 edition), and samples were taken at different time points during the fermenting process of SSP. The bacteria and fungi from samples at different time points in the fermenting process of SSP were cultured, isolated and purified by selective medium, and dominant strains were selected. The dominant bacteria were cultured in the designated liquid medium to prepare the fermentation broths, and GABA in the fermentation broth was qualitatively screened out by thin-layer chromatography. The microbial fermentation broth with GABA spots in the primary screening was quantitatively detected by online pre-column derivatization and high performance liquid chromatography established in our laboratory. GABA-producing microorganisms were screened out from predominant strains, and their GABA contents in fermentation broth were determined. The DNA sequences of GABA-producing bacteria and fungi were amplified using 16S rDNA and 18S rDNA sequences by PCR respectively. The amplified products were sequenced, and the sequencing results were identified through NCBI homology comparison. Molecular biological identification was made by phylogenetic tree constructed by MEGA 7.0 software. Through the homology comparison of NCBI and the construction of phylogenetic tree by MEGA 7.0 software, nine GABA-producing microorganisms were screened out and identified in this study. They were Bacillus subtilis, Enterococcus faecium, E. avium, Aspergillus tamarii, A. flavus, A. niger, Cladosporium tenuissimum, Penicillium citrinum and Phanerochaete sordida respectively. For the first time, nine GABA-producing microorganisms were screened out and identified in the samples at different time points during the fermenting process of SSP in this study. The results indicated that multiple predominant GABA-producing microorganisms exist in the fermenting process of SSP and may play an important role in the formation of GABA.
Bacteria ; classification ; metabolism ; Chromatography, High Pressure Liquid ; Fermentation ; Fungi ; classification ; metabolism ; Phylogeny ; Seeds ; microbiology ; Soybeans ; microbiology ; gamma-Aminobutyric Acid ; biosynthesis

Objective :To explore influence of small and dense low density lipoprotein (sdLDL) on in-stent restenosis after percutaneous coronary intervention (PCI).Methods : A total of 631 CHD inpatients ,who received PCI in our department from Feb 2015 to Feb 2017were followed up for 12 months ,and 240 cases were successfully followed up . According to coronary angiography (CAG) results ,the vascular diameter stenosis ≥50% regard as in-stent resteno-sis ,all patients were divided into restenosis group (n＝105) and no stenosis group (n＝135).Another 35 healthy volunteers undergoing physical examination simultaneously were treated as healthy control groups .Serum levels of sdLDL ,serum lipid TC ,TG ,HDL-C and LDL-C were measured and compared among all groups .Correlation be-tween serum sdLDL level and Gensini score was analyzed in CHD patients .Results : There were no significant difference in levels of serumlipids between restenosis group and no stenosis group , P＞ 0. 05 all.Compared with healthy control group ,there was significant rise in serum sdLDL level [ (0.451 ± 0.135) mmol/Lvs .(0.673 ± 0.281) mmol/L] in CHD group , P＝0.001 ;compared with no stenosis group ,there were significant rise in serum sdLDL level [(0.606 ± 0.276) mmol/L vs.(0.695 ± 0.304) mmol/L] and Gensini score [(40.23 ± 9.24) scores vs. (58.42 ± 10.37) scores] in restenosis group (P＝0.019 ,0.001) respectively.Linear correlation analysis indicated that serum sdLDL level was significant positively correlated with Gensini score in CHD patients ( r＝ 0.514 , P＝ 0.032).Conclusion :Elevated serum sdLDL level suggests high risk of in-stent restenosis in CHD patients .It can provide reference for disease condition assessment and adverse event prevention after PCI .

Objective:To study therapeutic effect of levosimendan combined milrinone on severe refractory heart failure (SRHF) and its influence on serum levels of brain natriuretic peptide (BNP) and uric acid (UA).Methods:A total of 156 SRHF patients were enrolled,randomly and equally divided into levosimendan group and milrinone group,both groups re-ceived corresponding medication based on routine treatment for 7d.Heart rate,blood pressure,serum BNP and UA levels,left ventricular end-systolic dimension (LVESd),left ventricular end-diastolic dimension (LVEDd) and left ventricular e-jection fraction (LVEF) before and after treatment,total effective rate and incidence of adverse reactions were observed and compared between two groups.Results:Compared with milrinone group after treatment,there were significant reduc-tions in heart rate [ (73.79 ± 7.61) beats/min vs.(70.39 ± 7.45) beats/min],systolic blood pressure [ (128.84 ± 13.11) mmHg vs.(121.86 ± 12.53) mmHg],scores of lung wet rales [ (2.05 ± 0.33) scores vs.(1.53 ± 0.21) scores],difficulty breathing [ (2.11 ± 0.36) scores vs.(1.60 ± 0.25) scores] and lower extremity edema [ (2.03 ± 0.34) scores vs.(1.50 ± 0.18) scores],serum levels of BNP [ (459.62 ± 46.27) μg/L vs.(248.73 ± 25.91) μg/L] and UA [ (355.97 ± 36.47) μmol/L vs.(282.75 ± 28.61) μmol/L],LVESd [ (41.62 ± 4.52) mm vs.(36.87 ± 3.71) mm] and LVEDd [ (51.89 ± 5.37) mm vs.(47.85 ± 4.83) mm],and significant rise in 24h urine volume [ (3204.59 ± 321.52) ml vs.(3695.78 ± 370.62) ml] and LVEF [ (42.36 ± 4.31)% vs.(47.85 ± 4.86)%] in levosimendan group,P＜0.01 all.Total effective rate of levosimendan group was significantly higher than that of milrinone group (89.74% vs.71.79%),and incidence rate of adverse reactions was significantly lower than that of milrinone group (5.13% vs.28.21%),P＜0.01 both.Conclusion:Levosimendan therapy can significantly reduce serum BNP and UA levels,improve cardiac function in SRHF patients.It possesses significant therapeutic effect,and it＇s safe and reliable,which is better than milrinone.