Background and purpose:The prognostic capability of traditional prognostic index like follicular lymphoma international prognostic index (FLIPI) is limited in the rituximab era. This study was to investigate the prognostic significance of peripheral blood absolute lymphocyte count/absolute monocyte count (ALC/AMC) in Chinese patients with follicular lymphoma (FL).Methods:This study retrospectively analyzed 136 newly diagnosed FL patients who received rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP)-like chemotherapy in Department of Hematology, Ruijin Hospital from Jan. 2003 to Dec. 2013, and further classified these patients according to FLIPI scoring system.Results:According to FLIPI, 61 patients (44.9%) were stratified into the low-risk (0-1 points) group, 42 cases (30.9%) into the intermediate-risk (2 points) group, and 33 cases (24.2%) into the high-risk (3-5 points) group. The overall response rate and 2-year progression-free survival (PFS) of the 3 risk groups were 88.5%, 95.2%, and 78.8% (P=0.090), and 91.4%, 74.6%, and 47.8% (log-rank=23.3,P<0.001), respectively. The overall response rate and 2-year PFS for patients with ALC/AMC≥4.7 and <4.7 were 91.9%, 68.6% (P=0.005) and 96.0%, 69.7% (log-rank=13.0,P<0.001), respectively. In the multivariate study, ALC/AMC≥4.7 was independent of FLIPI and was able to distinguish the FLIPI low-risk and intermediate-risk patients (log-rank=7.535,P=0.006).Conclusion:For FL patients treated with R-CHOP-like regimens, ALC/AMC is a simple and effective biomarker reflecting tumor microenvironment and human immunity, and could be considered for prognosis evaluation.

Purpose To analyze the high-frequency sonographic images of lymph nodes in mesenteric lymphadenitis of different ages. Materials and Methods 139 children with mesenteric lymphadenitis (study group) and 60 normal children (control group) were divided into 1 to 5 years, 6 to 10 years and 11 to 15 years group, the characteristics of high-frequency ultrasound sonographic images were analyzed, accuracy of longitudinal diameter (L), transverse diameter (S), aspect ratio (L/S) and color Doppler blood flow signal classification for the prediction of mesenteric lymph nodes swelling were evaluated using receiver operating characteristic (ROC) curve. Results Mesenteric lymph nodes in the control group appeared as spindle shape with sparse blood flow signals, L, and L/S increased with age increasing (F=4.047, 9.586;P<0.05). Mesenteric lymph nodes in the study group displayed as oval or teardrop-shaped with rich blood flow signals, L, S and L/S did not change significantly with age increasing (F=0.184, 1.084, 2.083; P>0.05). Compared with the control group, blood flow signals were more abundant in all age groups of the study group, L and S were also significantly higher (L:t=-13.798,-12.813,-8.089;S:t= -8.212,-13.172,-9.606, P<0.01), only in the 1 to 5 years group statistically significant difference (t=-3.208, P<0.05) was showed between the two groups. From 1 to 5 years, the sensitivity and specificity for the judgment of lymph node swelling were 95.56%and 100.00%, respectively when using L=9.85 mm as a standard;from 6 to 10 years, the sensitivity and specificity for the judgment of lymph node swelling were 95.59%and 100.00%, respectively when using L=10.25 mm as a standard;from 11 to 15 years, the sensitivity and specificity for the judgment of lymph node swelling were 92.31%and 100.00%, respectively when using S=4.40 mm as a standard. Conclusion High-frequency ultrasound is able to display the location distribution and morphological characteristics of the mesenteric lymph nodes in children, and also to accurately measure the diameters and flow signal distribution of the lymph nodes, thus will provide valuable evidence for the diagnosis of pediatric mesenteric lymphadenitis.

Objective To investigate the correlation between the rate of pathological complete response (pCR) and prognostic nutritional index (PNI) in gastric cancer patients who underwent neoadjuvant chemotherapy (NAC). Methods A total of 278 advanced gastric cancer patients who underwent NAC and R0 gastrectomy with D2 lymphadenectomy between January 2012 and March 2017 at the Affiliated Tumor Hospital of Zhengzhou University were analyzed retrospectively. Propensity score matching (PSM) was conducted to reduce the confounding bias between the groups (PNI＜45, 157 patients; PNI≥45, 121 patients). Multivariate analysis was used to determine the independent risk factors of the pCR rate in gastric cancer patients who underwent NAC. Results PNI (OR:3.026;95％ CI:1.261, 7.260;P = 0.013), differentiation (OR:0.470;95％ CI:0.270, 0.819;P = 0.008), and tumor location (OR:0.341;95％ CI:0.164, 0.708;P = 0.004) were the independent risk factors associated with the pCR rate of the gastric cancer patients who underwent NAC. After PSM, PNI (OR:2.728;95％ CI:1.130, 6.587;P = 0.026) was the independent risk factor associated with the rate of pCR after NAC. Conclusion Gastric cancer patients who underwent NAC with low PNI are less likely to get pCR than those with normal PNI.

Stroke has become the leading cause of disability and death in China. At present, intravenous thrombolysis is one of the most effective treatment for acute ischemic stroke, but not all patients can benefit from intravenous thrombolysis. In recent years, the exploration of predictive models for the outcomes after intravenous thrombolysis in patients with acute ischemic stroke has attracted increasing attention. This article systematically reviews the scoring models for predicting the functional outcome, death and symptomatic intracranial hemorrhage after intravenous thrombolysis in patients with acute ischemic stroke, with the aim of screening the scoring system suitable for clinical application and providing reference for the clinical diagnosis, evaluation and treatment of acute ischemic stroke.

OBJECTIVETo compare the clinical efficacy and safety among different chemotherapeutic regimens in treatment of refractory/relapsed acute myeloid leukemia (AML).

METHODSThe clinical data of 67 refractory/relapsed AML patients enrolled from September 2008 to April 2013 were collected. The differences of clinical outcome and adverse events among the patients treated with decitabine combined with DAG regimen, CAG regimen or "3+7" regimen were analyzed.

RESULTSAmong 19 patients in decitabine treatment group, 5 (26.3%) achieved complete remission (CR), 4 (21.1%) partial remission (PR), with overall response rate (ORR) of 47.4 %. Of 26 patients in CAG regimen group, 8 (30.8%) achieved CR, 1 (3.8%) PR, with ORR of 34.6%. Of 22 patients in "3+7" regimen group, 4 (18.2%) achieved CR, with ORR of 18.2%. The ORR of decitabine group was significantly higher than that of "3+7" group (P<0.05). However, no significant difference of ORR was observed among the three groups (P>0.05). It was interesting to note that in decitabine group, the marrow blast counts were lower in CR patients compared with those in non-CR patients (P<0.05), while this was not found in "3+7" group (P>0.05) and CAG regimen group (P>0.05). Adverse events in the three groups were similar, mainly including myelosuppression, pulmonary infection, nausea, vomiting and liver dysfunction, and could be well tolerated. Followed- up to September 2013, the median overall survival (OS) of decitabine group, CAG regimen group and "3+7" group after relapse was 7.5, 4 and 3 months, respectively (P>0.05), while significant difference was obtained between decitabine group and "3+7" regimen group (P<0.05).

CONCLUSIONDecitabine combined with DAG regimen is effective and well tolerated in refractory/relapsed AML patients who were unsuitable for intensive chemotherapy and hematopoietic stem cell transplantation, and the patients with low marrow blast counts are more suitable for the application of decitabine combined with DAG regimen.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Azacitidine ; administration & dosage ; analogs & derivatives ; Female ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Treatment Outcome ; Young Adult