[A Real-World Single-Center Study of Adult Hodgkin's Lymphoma].

OBJECTIVE: To summarize the clinical characteristics, therapeutic effect and prognostic factors of patients with Hodgkin's lymphoma (HL). METHODS: A total of 129 patients with HL diagnosed in Peking University Third Hospital from January 2010 to March 2021 who were given at least one efficacy assessment after treatment were enrolled, and their clinical data, including sex, age, pathological type, Ann Arbor stage, ECOG score, blood test, ß2-microglobulin, lactate dehydrogenase level, albumin level were collected. The clinical characteristics, therapeutic effect and long-term prognosis of the patients were summarized and analyzed. RESULTS: In classical HL, nodular sclerosis HL accounted for the highest proportion of 51.6%, followed by mixed cellularity HL (36.5%), lymphocyte-rich classical HL (3.2%), and lymphocyte depletion HL (0.7%), while nodular lymphocyte predominant HL accounted for 4.8%. The 3-year overall survival (OS) rate of HL patients was 89.8%, and 5-year OS was 85.0%. The 3-year progression-free survival (PFS) rate was 73.4%, and 5-year PFS was 63.1%. Multivariate regression analysis indicated that IPI score was an independent negative factor, while hemoglobin (Hb) level was an independent positive factor for OS in HL patients. When the mediastinal mass size was 9.2 cm, it was most significant to judge the survival status of HL patients. 5-year OS and 5-year PFS were 97.4% and 76.0% in early-stage HL patients without large mass, respectively, while in patients with advanced-stage HL was 83.4% and 55.9% (both P < 0.05). After 2-4 courses of treatment, the overall response rate (ORR) of patients who received chemotherapy combined with radiotherapy was 95.0%, while that was 89.6% in those with chemotherapy alone. CONCLUSIONS: The overall prognosis of patients with HL is satisfactory, especially those in early-stage without large mass. IPI score and Hb level are independent risk factors for the prognosis of HL patients. A 9.2 cm mediastinal mass can be used as the cut-off value for the prognosis of Chinese HL patients.

Postoperative abdominal herpes zoster complicated by intestinal obstruction: A case report.

BACKGROUND: Intestinal obstruction is a common occurrence in clinical practice. However, the occurrence of herpes zoster complicated by intestinal obstruction after abdominal surgery is exceedingly rare. In the diagnostic and treatment process, clinicians consider it crucial to identify the primary causes of its occurrence to ensure effective treatment and avoiding misdiagnosis. CASE SUMMARY: Herein, we present the case of a 40-year-old female patient with intestinal obstruction who underwent laparoscopic appendectomy and developed herpes zoster after surgery. Combining the patient's clinical manifestations and relevant laboratory tests, it was suggested that the varicella zoster virus reactivated during the latent period after abdominal surgery, causing herpes zoster. Subsequently, the herpes virus invaded the visceral nerve fibers, causing gastrointestinal dysfunction and loss of intestinal peristalsis, which eventually led to intestinal obstruction. The patient was successfully treated through conservative treatment and antiviral therapy and subsequently discharged from the hospital. CONCLUSION: Pseudo-intestinal obstruction secondary to herpes zoster infection is difficult to distinguish from mechanical intestinal obstruction owing to various causes. In cases of inexplicable intestinal obstructions, considering the possibility of a viral infection is essential to minimize misdiagnosis and missed diagnoses.

[Clinical Characteristics and Long-Term Survival of Patients with Chronic Lymphocytic Leukemia].

OBJECTIVE: To analyze the factors affecting the long-term survival of patients with chronic lymphocytic leukemia (CLL). METHODS: The clinical data of 101 newly diagnosed CLL patients from January 2010 to January 2021 were retrospectively analyzed. Rai and Binet staging systems were used for clinical staging, and CLL-IPI was used for risk stratification of the patients. RESULTS: There were 61 males and 40 females, the median age at diagnosis was 64 (28-84) years, the median PFS (progression-free survival) was 77（66-88） months, the 2-year and 5-year PFS rates were 85% and 64% respectively. The median OS (overall survival) was 108（103-112） months, the 5-year and 9-year OS rates were 74% and 46% respectively. Univariate analysis showed that high or very high risk of CLL-IPI, TP53 aberrations, del(17p), need for treatment and different treatment methods were the factors affecting OS (P<0.05); high or very high risk of CLL-IPI, TP53 aberrations, del(17p) and complex karyotype were associated with PFS (P<0.05). By X-tile analysis, it was found that the white blood cell count, the absolute neutrophil count, the hemoglobin level, and ß2-microglobulin level were associated with OS (P<0.05); the white blood cell count, the absolute lymphocytes count, the hemoglobin level, the platelet count, and the lactate dehydrogenase level were associated with PFS（P＜0.05）. CONCLUSION: The high or very high risk of CLL-IPI, TP53 aberrations, del(17p), need for treatment and different treatment methods are the factors affecting the OS of CLL patients, and high or very high risk of CLL-IPI, TP53 aberrations, del(17p) and complex karyotype are the factors affecting the PFS of CLL patients.

[Analysis of the Prognostic Value and Risk Factors of Early Relapse for Newly Diagnosed Multiple Myeloma Patients in the Era of Novel Agents].

OBJECTIVE: To investigate the influece of early relapse in the era of novel drugs on the prognosis of the patients with newly diagnosed multiple myeloma（NDMM） and risk factors, and to provide the basis for the early identification of the high-risk patients and guiding the treatment. METHODS: The clinical data of the patients with NDMM admitted to our hospital from November 2011 to May 2022 were retrospectively analyzed. According to whether the progression free survival（PFS） was more than 12 months, they were divided into early relapse group（≤12 months） and late relapse group（＞12 months）. The high-risk factors of the patients in two groups were analyzed, including age, anemia, renal insufficiency, hypercalcemia, increasing of lactate dehydrogenase（LDH） level, Extramedullary disease (EMD), International Staging System（ISS） stage, Revised International Staging System （R-ISS） stage, cytogenetic abnormalities(CA) detected by fluorescence in situ hybridization（FISH）, and treatment efficacy. The meaningful clinical indicators were screened, and multivariate analysis was used to explore the high-risk factors of early relapse. RESULTS: 170 patients with NDMM were collected, including 25 cases in early relapse group and 145 cases in late relapse group. The median OS time of the patients in early death group was 20 months, and 140 months in late relapse group by the end of follow-up, there was significant difference in OS of the patients between two groups（P<0.001）. Fifteen patients（56.0％）in early relapse group obtained ≥VGPR, and 113（77.9%） patients in late relapse group, the difference was statistically significant（P=0.011）. Survival outcomes remained poor among early relapse patients irrespective of depth of response to initial therapy. Multivariate analysis showed that the EMD and high-risk CA predicted early relapse. CONCLUSION: The prognosis of patients with early relapse in NDMM is poor. EMD and high-risk CA is an independent prognostic factor of early relapse.

[Clinical Characteristics and Prognosis Affecting-Factors of the Patients with Burkitt Lymphoma].

OBJECTIVE: To investigate the clinical characteristics and treatment outcome of patients with Burkitt lymphoma. METHODS: The clinical data of 27 patients with Burkitt Lymphoma were collected and retrospectively analyzed, the clinical characteristics, laboratory data, survival and the factors affecting the prognosis were also analyzed. RESULTS: Among the 27 patients (mainly for adults), the median age was 30 (15-83) years old, the ratio of male and female was 3.5∶1. There was no EB virus infection in all the patients, 92.6% of the patients showed extranodal organs involvement, 40.7% of them were leukemic stage, 85.2% patients belonged to Ⅲ and Ⅳ stage, 74.1% patients belonged to high/high-middle risk according to IPI index. In the terms of molecular biology, five patients were treated with next-generation sequencing test, and the MYC gene mutations were detected out in alt the patients, and the most common mutations were CCND3, ID3 and TP53. The overall response rate (ORR) for all the patients was 85.2%, the complete response (CR) rate was 63.0%, and the partial response rate was 22.2%, the 5-year progression-free survival rate and overall survival rate of the patients was 76.6% and 76.6%, respectively, which showed that the efficacy of the patients in high-dose methotrexate treatment group was higher than that in the non-high high-dose methotrexate treatment group. For the patients treated with LMB89 chemotherapy, the CR was 78.6%, ORR was 100%, the 5-year survival rate was 92.9%, which was superior to the patients treated with other regimens. Auto-hematopoietic stem cell transplantation as consolidation treatment could improve the prognosis for those patients who could not tolerate high-dose chemotherapy. Univariate analysis showed that ECOG score, the level of LDH>500 U/L, WBC level, CNS involvement, short-term effect and LMB89 regimen were the risk factors affecting the prognosis of the patients. CONCLUSION: The adult Burkitt lymphoma are highly aggressive. For the patients in high-dose methotrexate treatment group, especially LMB89 regimen can improve the survival of the patients, and to choose HSCT as a consolidation treatment can be a choice for those patients who could not tolerate high-dose chemotherapy.

[Analysis on Clinical Characteristics and Prognosis of 47 Patients with Extranodal NK/T Cell Lymphoma].

OBJECTIVE: To investigate the clinical features and prognostic factors of patients with extranodal NK/T cell lymphoma (ENKTL). METHODS: The clinical data of patients with ENKTL from November 2009 to November 2019 was collected and retrospectively analyzed to clarify the clinical features of ENKTL, and evaluate the factors that affected survival and prognosis. RESULTS: Forty-seven patients with ENKTL were collected, median age was 40 (12-82) years old, and more common in males than females, at the ratio of 1.47∶ 1. The median follow-up was 28 (1-112) months, and 5-year overall survival (OS) rate was 49.3%. The 5-year OS rates of the subjects with ECOG performance stage 0-1 and ≥2 were 51.6% and 0 (P=0.001), respectively. The 5-year OS rates of International Prognostic Index (IPI) score 0-1 and ≥2 were 60.0% and 40.6% (P=0.027), respectively. The 5-year OS rates of Ann Arbor staging Ⅰ/Ⅱ and stage Ⅲ/Ⅳ were 61.3% and 31.7% (P=0.005), respectively. The 5-year OS rates of the patients with presentation of B symptoms and without presentation of B symptoms were 79.0% and 30.1% (P=0.013), respectively. The 5-year OS rates of plasma EBV-DNA level < 5×102/ml and ≥ 5×102/ml were 60.4% and 33.3% (P=0.003), respectively. The 5-year OS rates of the patients receiving chemotherapy alone, combined chemotherapy and radiotherapy, and chemotherapy followed by autologous hematopoietic stem cell transplantation (auto-HSCT) were 12.9%, 86.5%, and 62.5% (P=0.001), respectively. Univariate analysis showed that ECOG score, IPI score, Ann Arbor staging, B symptoms, the copy number of EBV-DNA, and treatment regimens were statistically significant for OS. Multivariate analysis showed that ECOG score, B symptoms, the copy number of EBV-DNA, and treatment regimens were independent factors of ENKTL OS. CONCLUSION: ECOG score, B symptoms, the copy number of EBV-DNA, and treatment regimens are independent prognostic factors for OS of patients with ENKTL.

Autologous hematopoietic stem cell transplantation as first-line consolidation therapy can improve the prognosis of diffuse large B-cell lymphoma with high expression of MYC protein.

Myc-positive diffuse large B-cell lymphoma has lower curative efficacy and long-term survival than its negative counterpart, even when treated with R-CHOP regimen. The present study aims to determine whether the use of autologous hematopoietic stem cell transplantation as a consolidation therapy can improve the curative efficacy in this type of patients after achieving the best effect of chemotherapy for the first time. The data of 50 patients with Myc-positive diffuse large B-cell lymphoma were retrospectively analyzed. Autologous transplantation was performed for 23 patients, while transplantation was not performed for 27 patients. The clinicopathological features and survival conditions were compared. The 1-year and 3-year progression-free survival (PFS) rates were 66.7% ± 0.9% and 57.7% ± 1.0%, respectively, in the non transplantation group, and 100% and 82.1% ± 0.1%, respectively, in the transplantation group (P = .021). The 1-year overall survival (OS) rate for these two groups was 88.7% ± 0.6% vs 100%, respectively, while the 3-year OS rates for these two groups was 78.6% ± 0.1% vs 91.3% ± 0.1%, respectively (P = .176). Hematopoietic stem cell transplantation performed after chemotherapy is a risk factor for OS. Autologous hematopoietic stem cell transplantation as a consolidation therapy in the early stage can improve the prognosis of patients with Myc-positive diffuse large B-cell lymphoma.

[Clinical Characteristics and Prognosis of Acute Myeloid Leukemia with FLT3-ITD Mutation].

OBJECTIVE: To investigate the clinical characteristics of acute myeloid leukemia(AML) patients with FLT3-ITD(Fms-like tyrosine kinase3, intenal tandem duplication) mutation and their response to treatment. METHODS: Retrospective analysis of 128 newly diagnosed AML (except type M3) patients was performed between January 2014 and July 2017. Patients were divided into FLT3-ITD mutated group and non-mutated group. Mutation detection was carried out by using polymerase chain reaction(PCR) and gene sequencing analysis. Standard 3 + 7 or CAG regimen were taken as the first induction chemotherapy, 4 cases received sorafenib, overall survival (OS) was calculated by Kaplan-Meier. RESULTS: Ninety-seven patients can be evaluable for clinical data available; 4 patients were FLT3-TKD mutated, which accounted for 4.1%; 19 patients were FLT3-ITD mutated, which accounted for 19.59%(19/97). Median white blood cell count (WBC), percentage of peripheral blasts and LDH value were significantly higher in FLT3-ITD group than those in non-mutated group [64.65(1.07-587.92)×109/L vs 39.68 (0.45-203.81) ×109/L](P<0.01), [69.62(16-99)% vs 36.35(0-92) %](P<0.01 ) and [LDH 526(124-2 729)U/L vs 265(20-1977)U/L](P<0.05), respectively. The frequency of coexisting NPM1 mutation was higher in FLT3-ITD group than that in non-mutated group [36.8(7/19)% vs 6.8 (5/74) %](P<0.01). The CR+PR was lower in FLT3-ITD group than that in non-mutated group [31.6(6/19)% vs 64.9 (48/74)%](P<0.05). OS in FLT3-ITD group was significantly shorter than that in non-mutated group (5 vs 18 months)(P<0.05). There is no significant difference in OS between FLT3-ITD concomitant with and without NPM1 mutation groups(5 vs 5 months)(P>0.05). The median OS was 13 months for the FLT3-ITD patients taking sorafenib. CONCLUSION: The FLT3-ITD is a common mutation in AML, FLT3-ITD mutated AML is more likely concomitant with NPM1 mutation with higher number of WBC, percentage of peripheral blasts and LDH value, thus CR is low after the 1st treatment and survival is poor.

[Research Progress of Cell Immunotherapy in Treatment of Hematological Malignancies-Review].

Cell immunotherapy, as an important mean of tumor therapy, infuses a large number of immune effector cells amplified in vitro to the patients, resulting in the anti-tumor effect. There have been a series techniques of cell immunotherapy, including T lymphocyte therapy, dendritic cell-based immune cell therapy, natural killer cell therapy, gamma delta T cell therapy and so on. The preparation and culture conditions, anti-tumor mechanism, target cells etc of these immune cells are not the same, the each with its advantages and disadvantages. Many clinical studies have showed that the patients with a variety of tumors including hematological malignancies, who adopted cell immuno-therapy, had the prolonged survival, an improved quality of life, and with the less adverse reactions. This review summarizes the available data on the characteristics of different cell immunotherapies and their application in hematological malignancies.

[Analysis of Clinical Feature and Curative Efficacy of 30 Patients with T Cell Lymphoblastic Lymphoma].

OBJECTIVE: To analyze clinical feature and curative efficacy of patients with T cell lymphoblastic lymphoma(T-LBL). METHODS: The clinical data including clinical features, laboratorial results, survival and prognostic factors from 30 patients with T-LBL were retrospectively analyzed. RESULTS: Median age of 30 cases was 24.5 years, 25 (83.3%) patients were at high-intermediate and high risk by IPI, extranodal disease was present in 73.3% of the patients, 17(56.7%) patients had bone marrow involvement and 19(63.3%) had mediastinal masses. The overall response rate(ORR) for the whole group was 80.0%, the complete response rate was 36.7%, the 3-5-year overall survival rate was 37.1% and 26.0%, respectively. Compared with NHL-like regimens, ALL-like chemotherapy could improve the survival of patients, the 3-year overall survival rate was 59.1% vs 27.3%. For adult patients, the median overall survival time was 35 months vs 13 months in HSCT group and chemotherapy group, there was a statistically significant difference(P=0.019). ECOG score, IPI score, anemia, the level of LDH and ß2-MG, therapy regimens, the short-term efficacy and the level of fibrinogen were the related factors for prognosis. CONCLUSION: T-LBL is more common in young men, with large mediastinal mass and bone marrow involvement. ALL-like chemotherapy regimens are superior to NHL-like regimens, HSCT can improve the survival and reduce the recurrence of adult patients. Chemotherapy combined with allogeneic DC/CIK immune cell treatment can be used in relapsed patients.

Melittin induces human gastric cancer cell apoptosis via activation of mitochondrial pathway.

AIM: To investigate the apoptotic effects of melittin on SGC-7901 cells via activation of the mitochondrial signaling pathway in vitro. METHODS: SGC-7901 cells were stimulated by melittin, and its effect on proliferation and apoptosis of was investigated by methyl thiazolyl tetrazolium assay, morphologic structure with transmission electron microscopy, annexin-V/propidium iodide double-staining assay, measuring mitochondrial membrane potential (MMP) levels, and analyzing reactive oxygen species (ROS) concentrations were analyzed by flow cytometry. Cytochrome C (Cyt C), apoptosis-inducing factor (AIF), endonuclease G (Endo G), second mitochondria-derived activator of caspases (Smac)/direct IAP binding protein with low isoelectric point (Diablo), and FAS were analyzed by western blot. The expression of caspase-3 and caspase-8 was measured using activity assay kits. RESULTS: Melittin was incubated at 1.0, 2.0, 4.0, or 6.0 µg/mL for 1, 2, 4, 6, or 8 h and showed a time- and concentration-dependent inhibition of SGC-7901 cell growth. Melittin induced SGC-7901 cell apoptosis, which was confirmed by typical morphological changes. Treatment with 4 µg/mL melittin induced early apoptosis of SGC-7901 cells, and the early apoptosis rates were 39.97% ± 3.19%, 59.27% ± 3.94%, and 71.50% ± 2.87% vs 32.63% ± 2.75% for 1, 2, and 4 h vs 0 h (n = 3, P < 0.05); the ROS levels were 616.53% ± 79.78%, 974.81% ± 102.40%, and 1330.94% ± 93.09% vs 603.74% ± 71.99% (n = 3, P < 0.05); the MMP values were 2.07 ± 0.05, 1.78 ± 0.29, and 1.16 ± 0.25 vs 2.55 ± 0.42 (n = 3, P < 0.05); caspase-3 activity was significantly higher compared to the control (5492.3 ± 321.1, 6562.0 ± 381.3, and 8695.7 ± 449.1 vs 2330.0 ± 121.9), but the caspase activity of the non-tumor cell line L-O2 was not different from that of the control. With the addition of the caspase-3 inhibitor (Ac-DEVD-CHO), caspase-3 activity was significantly decreased compared to the control group (1067.0 ± 132.5 U/g vs 8695.7 ± 449.1 U/g). The expression of the Cyt C, Endo G, and AIF proteins in SGC-7901 cells was significantly higher than those in the control (P < 0.05), while the expression of the Smac/Diablo protein was significantly lower than the control group after melittin exposure (P < 0.01). Ac-DEVD-CHO did not, however, have any effect on the expression of caspase-8 and FAS in the SGC-7901 cells. CONCLUSION: Melittin can induce apoptosis of human gastric cancer (GC) cells through the mitochondria pathways, and it may be a potent agent in the treatment of human GC.

[Detection of Molecular Cytogenetic Aberrations by Fluorescence in Situ Hybridization in Different Bone Marrow Samples of Multiple Myeloma].

OBJECTIVE: To detect the molecular cytogenetic abnormalities in different bone marrow samples of multiple myeloma by using fluorescence in situ hybridization (FISH) technology. The bone marrow cells from 48 cases of MM were taken for sorting the plasma cells using CD138 magnetic beads, and the biopsy tissue from 10 cases of MM was taken and embedded in parafin, then the 2 kinds of samples were detected by using FISH. D13s319/RB1, 1q21/P53, IgH, IgH/FGFR3, IgH/MAF probes were detected in 58 patients with new diagnosed multiple myeloma (MM) by FISH technology. RESULTS: Fluorescent signals were both seen in 2 different types of bone marrow samples and cytogenetic aberrations were detected in 30/58 (51.7%) patients, 29.3% (17 out of 58) cases had both D13S319 and RB1 deletion. The positive rates of P53 deletion, 1q21 amplification and IgH rearrangement were 12%, 27.6% and 20.7%, respectively. Only 7 cases (23.3%) had one cytogenetic abnormality, other 23 (76.7%) cases all had 2 to 5 kinds of different abnormalities. CONCLUSION: More than half of MM patients have cytogenetic change, and most of them are complex chromosomal abnormality. The different kinds of samples can expand the useful extension of FISH technology and acquire more cytogenetic information for clinician.

[Clinical analysis of 13 patients with primary bone lymphoma].

OBJECTIVE: To analyse the clinical featuers, prognositic factors and treatment outcomes of primary bone lymphoma(PBL). METHODS: The clinical data of 13 patients with PBL in our hospital from 2005 to 2014 were analysed retrospectively. RESULTS: The median age of these patients was 40 (25-71) years old, ostealgia was the initial symptom(100%). The main histologic type was diffuse large B cell lymphoma (DLBCL) (11/13, 84.6%), and among other 2 cases 1 case was anaplastic large cell lymphoma(ALCL) and other 1 case was B lymphoblastic lymphoma. All 13 cases were treated with chemotherapy, 6 cases got complete remission(46.2%) and 7 cases got partial remission(53.8%). There was no statistical relation of age, sex, stage, ß2-MG level, LDH level, pathological type and the application of rituximab with the complete remission rate (P>0.05). After the median follow up of 12 (3-72) months, 3 cases died of diease progression and 6 cases maintained in complete remission, the median progression-free survival was 13 (2-72) months. CONCLUSION: The most common histologic type is DLBCL, its main treatment method is the combined chemical therapy, but the role of rituximab in treatment is not clear, thus larger clinical trial is necessary.

[Clinical characteristics and therapeutic efficacy of immunoglobin D multiple myeloma].

This study was aimed to evaluate the clinical characteristics of immunoglobin D multiple myeloma (IgD MM) and its curative efficacy. The clinical data of 15 cases of newly diagnosed IgD MM from April 1993 to June 2013 were analyzed retrospectively. Among 15 cases received induction treatment, the traditional chemotherapy was carried out in 9 cases, bortezomib-based therapy was performed in 6 cases. The diagnostic criteria and disease response criteria of MM were based on International Myeloma Working Group (IMWG) criteria,survival time was analyzed by using Kaplan-Meier method, the median age of patients was 57 years (range 40-72), the ratio of male to female was 2:1, the MM patients in Durie-Salmon stage III accounted for 100% (15/15) , the MM patients with λ light chain accounts for 80% (12/15) , with bone lesion 86.7% (13/15), with pleural effusion 26.7% (4/15) , with renal impairment (RI) 86.7% (13/15) ,with anemia 93.3% (14/15) , with serum album<35 g/L 26.7% (4/15). The median creatinine clearance rate (Ccr) of patients was 23.1 (6-44) ml/min, and median hemoglobin level was 82 (43-131) g/L. The results showed that in followed-up 11 cases, 8 cases died, 3 cases survived; the average duration of follow-up for these cases was 20 (0.5-138) months, the median progression-free survival time (PFS) was 7 (95%CI4.6-9.4) months, and the median overall survival (OS) time was 15 (95%CI6.6-27.4 ) months. Compared traditional chemotherapy with bortezomib regimen therapy,median OS time was 17 (95%CI6.1-28.0) months vs 15 (95%CI 0.0-33.3) months (P = 0.90) . Assessable curative effect of 14 cases was as follows: CR 33.3% (5/15); VGPR 13.3% (2/15); PR 20% (3/15); SD 20% (3/15); PD 6.7% (1/15). It is concluded that IgD MM is a rare type of MM and has a poor prognosis. Bortezomib may be beneficial for some patients with extramedullary infiltration. Autologous hematopoietic stem cell transplantation may improve survival time.

[Analysis of clinical features and prognostic factors in 59 cases of follicular lymphoma].

This study was aimed to explore the clinical features and related prognostic factors of follicular lymphoma (FL). The total of 59 newly diagnosed FL patients were analyzed retrospectively in term of age, sex, clinical manifestation, laboratory data, pathological examination, clinical stage and so on, so as to find out the related prognostic factors. The results showed that the median age of the 59 patients was 55 years, among them the male-female ratio was 1: 1.36. Among the 64.4% cases with the involvement outside lymphonode , the bone marrow involvement accounted for 28.8%, while the involvement of gastrointestinal tract and skeleton was in the second place. The rate of BCL-2/JH gene rearrangement was 30.3%, III-IV of clinical stage accounted for 71.2% in these FL patients. During the follow up of the 56 patients, OR and CR rates were 96.4% and 80.3% respectively, 5 year-and 10 year overall survival rates were 88.2% and 74.1% respectively, the relapse rate was 33.9%. Univariate analysis showed that the age, the longest diameter of involved node, gastrointestinal involvement, serum lactate dehydrogenase, ECOG, IPI, aaIPI, FLIPI, FLIPI2 and whether initial therapy could achieve CR or not were influencing factors of prognosis for FL patients. Multivariant analysis showed that the gastrointestinal involvement, IPI, aaIPI and whether initial therapy could achieve CR or not were independent prognostic factors for OS. The relative mortality risk of patients without CR was 70 times of patient with CR. It is concluded that the newly diagnosed FL is more observed in middle to old aged females, displaying frequent bone marrow involvement, less frequent BCL-2/JH gene rearrangement, III-IV of clinical staging, and high relapse rate, but longer survival time. The gastrointestinal involvement, IPI, aaIPI and whether CR can be achieved or not after initial therapy are independent prognostic factors for FL patients.

[Clinical observation and long-time follow-up of patients with malignant lymphoma treated with autologous peripheral blood hematopoietic stem cell transplantation].

This study was purposed to evaluate the efficacy of autologous peripheral blood hematopoietic stem cell transplantation (auto-PBHSCT) for patients with malignant lymphoma. From January 1992 to June 2012, 32 malignant lymphoma (ML) patients were treated with auto-PBHSCT in our hospital. There were 56 cases of non-Hodgkins lymphoma (NHL) and 16 cases of Hodgkin's lymphoma(HD). The preconditioning regimens of total body irradiation (TBI) plus cyclophosphamide combined with etoposide/pharmorubicin were used in 50 patients, and the BEAM (BCNU+etoposide+Ara-C+melphalan) were used in the other 22 patients. The average number of CD34(+) cells was (6.6 ± 4.9) ×10(6)/kg. The results showed that transplanted cells were engrafted and hematopoiesis was reconstituted in all patients. The median time of neutrophilic granulocyte recovery up to ≥ 0.5×10(9)/L was 12 ± 4.4 days, and the platelet recovery up to ≥ 20×10(9)/L was 14 ± 4.9 days . The transplantation related mortality was 4.2%. The patients were followed up for 6-217 months. The median follow-up time was 63.5 months. 1-year OS rate was 92.3 ± 3.2%. 3-years OS rate was 81.4 ± 4.9%. 5-years OS rate was 77.6 ± 5.3%. 10-years OS rate was 68.9 ± 6.8%. It is concluded that auto-PBHSCT is effective for malignant lymphoma, and long time follow-up shows that the OS rate is still high. Furthermore, the safety of auto-PBHSCT can also be received. Before transplantation the patients with CR can get higher OS rate.

Neohesperidin attenuates cerebral ischemia-reperfusion injury via inhibiting the apoptotic pathway and activating the Akt/Nrf2/HO-1 pathway.

Oxidative stress is well known to play a pivotal role in cerebral ischemia-reperfusion injury. On the basis of this fact, antioxidative agents have been demonstrated to be neuroprotective. Neohesperidin (NH) is abundant in citrus flavonoids and possesses reactive oxygen species scavenging activity and neuroprotective effects in vitro. However, little is known about its effects on cerebral ischemia-reperfusion injury and the underlying mechanisms. In this study, we use a rat model of middle cerebral artery occlusion (MCAO) to investigate the neuroprotective effects of NH. NH significantly improved neurological functions and attenuated MCAO-induced infarct volume, pathological changes, and neuronal loss. Moreover, it enhanced antioxidant capacity and suppressed oxidative stress in the brain. NH inhibited the MCAO-induced upregulation of Bax, cytochrome c, and cleaved caspase-9 and -3, as well as the downregulation of Bcl-2. Interestingly, NH treatment upregulated heme oxygenase-1 (HO-1) in a concentration-dependent manner, which was due to the NH-mediated activation of the protein kinase B (Akt)/nuclear factor erythroid 2-related factor 2 (Nrf2) pathway. NH also abolished the MCAO-induced inhibition of the Akt/Nrf2 pathway. In conclusion, NH attenuates cerebral ischemia-reperfusion injury via the inhibition of neuronal apoptosis and oxidative stress through the regulation of the apoptotic pathway and the Akt/Nrf2/HO-1 pathway. NH might be a promising preventive agent for ischemic stroke.

[Clinical characteristics and prognostic factors of 62 cases with Hodgkin lymphoma].

OBJECTIVE: To investigate the clinical characteristics, pathologic types and prognostic factors of Hodgkin lymphoma (HL). METHODS: Retrospective analyses of clinical data of 62 HL patients, including 45 from Peking University third hospital and 17 from Shanxi Dayi hospital. RESULTS: Sixty-two HL patients accounted for 5.66% of the total newly diagnosed patients with lymphoma (45/795) in the period with a ratio of male:female as 2.1:1. All the pathological types were classical Hodgkin lymphoma (cHL), including 33 cases (53.2%) of nodular sclerosis type (NS) and 19 cases (30.6%) of mixed cell type (MC). Of the 56 cases followed up, the total responsive rate was 92.9% , and 2- , 3- and 5- year overall survival (OS) rates were 97.7%, 92.2% and 80.5% respectively with the median OS as 45 (8-184) months. Analyses of the prognostic factors indicated that the involvement of spleen(P=0.042)and German Hodgkin Study Group(GHSG) risk score (P=0.002) were poor factors with statistic significance. CONCLUSION: HL is one of the curable malignant tumors, 5-year OS rate was 80.5% in this group. After recurrence, part of patients developed slowly and could be salvaged with second-line therapy with high remission rate. GHSG scoring system and involvement of spleen could predict the prognosis in HL setting.

Differential sensory gating functions between smokers and non-smokers among drug-naive first episode schizophrenic patients.

Although an acute effect of cigarette smoking and nicotine on sensory gating of schizophrenias has been investigated in published papers, the chronic effect of cigarette smoking on this phenomenon has not yet been reported. We report the effects of chronic cigarette smoking, without new acute exposure before testing, on sensory gating using the P50 auditory evoked potential in a group of drug-naive first episode schizophrenic smokers and healthy smokers. Sensory gating was evaluated using auditory P50 suppression elicited using the conditioning (S1)-testing (S2) paradigm. Fifty six male drug-naive first episode schizophrenic patients were compared to 41 healthy male controls. Patients were classified into subgroups of current smokers (n=18) and non-smokers (n=38) to explore the effects of smoking on sensory gating. All subjects did not smoke a cigarette for at least 1h prior to testing. Schizophrenic patients showed an increased S2 amplitude and a poorer sensory gating as measured by both S2/S1 ratio and S1-S2 difference of P50 amplitude, as compared to healthy controls. However, smokers showed an increased S1 amplitude and better sensory gating than did non-smokers both in schizophrenia patients and healthy controls. Our findings support a sensory gating deficit among first episode schizophrenic patients. However, it was less pronounced among schizophrenic patients who were current cigarette smokers, suggesting a positive effect of chronic cigarette smoking on ameliorating this sensory gating deficit in schizophrenia. Our findings of the present study present new evidence supporting the self-medication hypothesis of self-medication by cigarette smoking in schizophrenia to possibly ameliorate pre-existing functional deficits.