Dose-adjusted EPOCH-R vs. R-CHOP in frontline management of Waldeyer's ring diffuse large B-cell lymphoma: a retrospective study from a single institution / 中华医学杂志(英文版)

BACKGROUND@#To compare the efficacy and safety of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin plus rituximab (DA-EPOCH-R) with standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in Waldeyer's ring diffuse large B-cell lymphoma (WR-DLBCL) at a single institution.@*METHODS@#This retrospective study included 115 newly diagnosed patients with WR-DLBCL, of whom 68 patients received R-CHOP, and 47 patients received DA-EPOCH-R as their first-line treatment. The baseline features of the two groups were well balanced using a 1:1 propensity score matching method, and a total of 84 cases were obtained, including respective 42 cases in the R-CHOP and DA-EPOCH-R groups, for further survival and prognosis analysis. The primary objectives included progression-free survival (PFS) and overall survival (OS).@*RESULTS@#During a median follow-up of 45 months, there were nine (21.4%) deaths in the R-CHOP group and two (4.8%) in the DA-EPOCH-R group. Kaplan-Meier analysis showed statistically significant improvements in PFS and OS in patients with DA-EPOCH-R compared with those treated with R-CHOP (log-rank test, P  = 0.025 and P  = 0.035, respectively). The 2-year PFS and OS rates in the DA-EPOCH-R group were 90.1% (95% confidence interval [CI]: 81.4-99.8%) and 95.2% (95% CI: 89.0-100.0%), respectively, and 80.5% (95% CI: 69.3-93.6%) and 90.5% (95% CI: 52.8-99.8%) in the R-CHOP group. Patients without B symptoms and elevated lactate dehydrogenase levels had a higher PFS in the DA-EPOCH-R group, with P values of 0.038 (hazard ratio [HR]: 0.11; 95% CI: 0.01-0.88) and 0.042 (HR: 0.19; 95% CI: 0.04-0.94), respectively. There were no statistically significant differences in clinical responses and treatment-related toxicities between the two groups.@*CONCLUSION@#Compared with patients received R-CHOP, those treated by DA-EPOCH-R had superior PFS, OS, and controlled toxicity in patients with WR-DLBCL.

The CT findings of ossification in sinonasal inverted papilloma and its comparison with the originating site determined during surgery / 中华放射学杂志

Objective:To evaluate the CT characteristics of ossifying foci in sinonasal inverted papilloma (IP) and to compare with the tumor root shown intraoperatively.Methods:The clinical and CT imaging data of 127 patients with IP, which were proved by histopathology, were reviewed retrospectively from Beijing Tongren Hospital, Capital Medical University, during the period from January 2012 to December 2018. The number, location, shape, density of ossifying foci in sinonasal IP and the relationship with the wall of sinus were observed. The sites of ossification on CT scans were compared with the root of the tumors described in the corresponding patient′s operative records.Results:In 127 IP patients, 51 (40.2%) patients showed the ossification in the tumor on CT. Single ossifying foci were found in 35 cases and multiple in 16 cases. The ossification affected single site of the sinonasal tract ( n=16) or distributed diffusely ( n=35). In the 50 cases, the ossifying foci extended along the long axis of the affected sinus appearing as branched ( n=19), striped ( n=16), linear ( n=7), lumpy ( n=2) or mixed type ( n=6), and 1 case was located at the edge of the maxillary sinus. Totally 66.7% (34/51) of the ossifying focis contained peripherally hyperdense bone tissue and centrally hypodense adipose tissue, which corresponded to bone cortices and fatty marrow of the trabecular bone. And 96.1% (49/51) of the ossifying focis were attached to the adjacent bone of the sinus, and the sites of attachment were concordant with the actual origin of tumor confirmed in operation . Conclusions:Ossification can be seen in some sinonasal IPs. Tracing along ossifying focus to the site of attachment with sinus might facilitate preoperative prediction of the originating site of tumor.

Advances in IgG4-related sinonasal diseases / 中华耳鼻咽喉头颈外科杂志

IgG4 related disease (IgG4-RD) is an independent clinical pathological entity which is different from common chronic inflammation and other autoimmune diseases in recent years. It often appears in the form of tumor like tissue-destructive lesions and may be accompanied by the increase of concentration of serum IgG4. Histopathology is characterized by a large number of lymphocytes and plasma cells infiltration, storiform fibrosis and occlusive phlebitis. The characteristics of IgG4-RD in nose and sinuses have not been widely investigated. The aim of the present study is to review the advances in IgG4 related sinonasal diseases from four aspects including pathogenesis, clinical features, treatment and future research directions.

Improving the satisfaction of hospital staff: an attempt at Enterprise WeChat / 中华医院管理杂志

Objective To explore the application and effect of enterprise WeChat in improving hospital staff satisfaction. Methods Medical staff from Beijing Tongren Hospital were randomly recruited, and divided into an observation group and a control group according to whether they keep track of WeChat enterprise account prior to the first survey. In December 2016, a satisfaction survey was conducted, followed by the increased frequency and content of WeChat service, as well as 7 newly introduced service applications. The second survey was made in December 2017. Propensity score matching was applied to the respondents of the two questionnaires, to eliminate such differences as gender, age, and education between the two surveys. Chi-square test was used to analyze the difference of satisfaction between the observation group and the control group before and after improving the WeChat service. Results Compared with the control group, the observation group has made significant improvement in 8 items, including "efforts made by the hospital to improve the practice environment of medical staff","current work intensity and pressure","complaint handling", "performance bonus distribution", "administrative and logistical staff's clinical front-line service", " continue to work in our hospital", " consciously safeguard the reputation of the hospital","overall satisfaction with the hospital". There was no significant difference between the 11 items, and none of them decrease (P<0. 05). Conclusions Enterprise WeChat can improve staff satisfaction in 6 dimensions:working environment, workload, welfare and pay, service guarantee, identification and honor, and overall evaluation.

Practice and insight on strengthening hospital culture by WeChat / 中华医院管理杂志

This paper described the application of WeChat public platform and WeChat groups in hospital culture development.As proposed by the authors,WeChat can be used by the hospitals to strengthen media integration,cultivate medical personnel′s media literacy,improve the supervision mechanism of WeChat,take tide of the new media trend,and adhere to the cultural development,thus leading the reform and development of the hospital.

IgG4 immunohistochemistry in granulomatosis with polyangiitis / 中国耳鼻咽喉头颈外科

OBJECTIVE To obser ve t he histopathological features and immunohistochemical expression of IgG4 in nasal granulomatosis with polyangiitis(GPA) and to study the relationship between GPA and IgG4-related disease(IgG4-RD). METHODS A total of 12 nasal GPA patients were collected from the Department of Pathology, Beijing TongRen Hospital during January 2012 to December 2016. EnVision immunohistochemical technique was used to detect the expressions of CD38, CD138, IgG and IgG4. RESULTS Nine cases were found pulmonary abnormalities. Elevated titer of anti-neutrophil cytoplasmic antibody was presented in 8 cases in this study. On histopathologic evaluation, 8 of 12 cases were graded as pathologic score 3, one as score 2, and the remaining 3 as score 1. Eight cases showed increased number of IgG4+ cells higher than 10/HPF, 2 of which showed the ratio of IgG4+/IgG cells were more than 40％. CONCLUSION IgG4+ cells can be increased in biopsies of nasal GPA. Since the morphologic and clinical manifestations of GPA and IgG4-RD may overlap, it could be a significant diagnostic pitfall in the differential diagnosis of these two entities. The diagnosis of GPA should combine clinical manifestations, imaging findings, serological examinations and pathological features.

IgG4-related sialodacryoadenitis and chronic rhinosinusitis: a clinicopathologic analysis of 13 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic characteristics of IgG4-related sialodacryoadenitis and chronic rhinosinusitis (CRS).</p><p><b>METHODS</b>A total of 13 patients (patient group) were evaluated clinically and biopsy specimens from the lacrimal/salivary glands (n=12) and nasal mucosa (n=8) were reviewed and immunohistochemistry was performed to assess IgG-and IgG4-positive cells. Similarly, nine patients with IgG4-related sialodacryoadenitis without CRS and 10 patients with common CRS were included as controls.</p><p><b>RESULTS</b>There were 8 male patients and 5 female patients. The age of patients ranged from 32 to 71 years (mean 50.2 years). The patient group had higher serum IgG4 concentration than that of the control group (P<0.05). Lymphoplasmacytic infiltration, lymphoid follicle formation and sclerosis were prominent in lacrimal/salivary glands in both groups; however the magnitude of IgG4-positive plasmacytic infiltration in the patient group was significantly higher than that of the control group (P<0.05). Similarly, evaluation of nasal mucosa revealed greater lymphocytic and plasmacytic infiltration, and lymphoid follicle formation, together with significantly higher amount of IgG4-positive plasma cell infiltration in the patient group compared to the common CRS group (P<0.05).</p><p><b>CONCLUSIONS</b>IgG4-related disease (IgG4-RD) simultaneously involving lacrimal/salivary glands and nasal cavity/paranasal sinuses is rare and characterized by a combination of IgG4-positive plasma cell infiltration involving lacrimal/salivary glands and nasal mucosa along with an increased serum level of IgG4. As a systemic disease, early and accurate diagnosis is therefore of great importance, and unnecessary surgery should be avoided.</p>

Prognostic significance of NAD (P) H-quinone oxidoreductase 1 overex-pression in ovarian mucinous cystadenocarcinoma / 中国病理生理杂志

AIM: To investigate the significance of NAD (P)H-quinone oxidoreductase 1 (NQO1) protein overexpression for prognostic evaluation of ovarian mucinous cystadenocarcinoma .METHODS:NQO1 protein was detected in 162 cases of ovarian mucinous cystadenocarcinoma , 35 cases of ovarian mucinous cystadenoma and 29 samples of normal ovarian epithelial tissues by the method of EnVision immunohistochemical staining .The correlation between high expression of NQO1 protein and clinicopathological features of ovarian mucinous cystadenocarcinoma was also evaluated .Overall sur-vival and disease-free survival rates of ovarian mucinous cystadenocarcinoma patients were calculated by Kaplan -Meier method.RESULTS:The positive rate and strongly positive rate of NQO 1 protein were 85.8%and 64.2%in ovarian mu-cinous cystadenocarcinoma , respectively , which are significantly higher than those in ovarian mucinous cystadenoma , and normal ovarian epithelial tissues ( P <0.01 ) .NQO1 expression was significantly correlated with the histological grade (P<0.05) and clinical stage (P<0.01) of ovarian mucinous cystadenocarcinoma .Kaplan-Meier survival analysis showed that the overall survival rate and disease-free survival rate were significantly higher in ovarian mucinous cystadenocarcinoma patients with high NQO1 expression than those with low NQO1 expression (P<0.01).CONCLUSION:NQO1 expression is closely correlated with the progression and prognosis of the patients with ovarian mucinous cystadenocarcinoma .High ex-pression of NQO1 protein may be used as an important indicator for the patients with poor prognosis of ovarian mucinous cystadenocarcinoma .