Recently, double-hit lymphoma (DHL) was clarified to be a molecular category of B-cell lym-phoma, which was mainly related to MYC and Bcl-2 genes translocation. Fluorescence in situ hybridization (FISH) is the gold standard of diagnosis and it is controversial to detect the expression of MYC and Bcl-2 protein by immuno-histochemistry. DHL, which was found to be aggressive according to many retrospective analyses, mainly develops in patients with diffuse large B-cell lymphoma and grey zone lymphoma. Both rituximab combination and transplant consolidation were not able to signiifcantly overcome the poor prognosis of DHL. Novel and speciifc molecular targeted agents need to be explored and investigated in order to improve the treatment outcome.

Multi-disciplinary modality treatment is the optimal therapeutic strategy for locally advanced squamous cell carcinoma of head and neck (SCCHN). Recently, molecular targeted agents have been tested in this setting. Epithelial growth factor receptor (EGFR) is the major therapeutic target because of its universally high expression in SCCHN. As a human-mouse chimeric monoclonal antibody, cetuximab is the only molecular targeted agent approved in SCCHN. As compared with radiotherapy alone, radiotherapy in combination with cetuximab was proved to improve progression-free and overall survival in patients with locally advanced SCCHN. However, randomized comparison between radiotherapy plus cetuximab and conventional concurrent chemoradiotherapy (CCRT) is limited in term of efficacy and toxicity. Although RTOG 0522 study demonstrated it is ineffective to combine cetuximab with CCRT, the optimal chemotherapy agent partner with cetuximab warrants further investigation. For other anti-EGFR inhibitors, how to wisely design pertinent clinical studies based on available evidence is the key for success.

Along with the extensive understanding of differentiated thyroid cancer (DTC), its distinct molecular genotype and signaling pathway was revealed, which improved the development of molecular-targeted therapy. Regarding radioactive iodine-refractory DTC, multiple multikinase inhibitors including sorafenib and lenvatinib, which target vascular endothelial growth factor (VEGF) pathway, were proved to be effective. Moreover, selective inhibitors and redifferentiation agents were shown to be promising. In the future, individual genetic testing would provide more speciifc information in directing individualized molecular-targeted therapy.

Gynecological malignant tumors, including cervical tumors, endometrial tumors and ovarian tumors, can be treated by laparoscopy.Lymphocele is one of the common postoperative complications after pelvic lymphadenectomy.However, lymphocele is not fatal, and the clinical symptoms were associated with the lymphocele size.Hence, we reviewed advances in diagnosis and treatment of lymphocele after laparoscopic lymphadenectomy.

The predominant type of head and neck cancer is head and neck squamous cell carcinoma (HNSCC), which needs more effective treatment. As a highly immunosuppressive malignancy, HNSCC has 3 major mechanisms including induction of immune tolerance, local immune evasion, and disruption of T-cell signaling. Immune checkpoint plays a critical role in the function of T-cell and rapid development has been achieved by inhibiting programmed cell death 1 (PD-1). As anti-PD1 humanized monoclonal antibodies, pembrolizumab and nivolumab have proven to be effective in the salvage treatment for recurrent or metastatic HNSCC, further investigation is awaited.

Objective To investigate the difference in healthcare-associated infection (HAI)status and antimicro-bial resistance of Acinetobacterbaumannii(A.baumannii)isolated from different wards,so as to provide evidence for effective prevention and therapy for HAI caused by A.baumannii.Methods Clinical data of 446 A.baumannii isolates from hospitalized patients between January 2012 and July 2013 were analyzed retrospectively. Results The majority of 446 A.baumanniiisolates were from patients admitted to intensive care unit (ICU,n= 236,52.92% ), followed by departments of respiratory diseases(n= 55,12.33% )and neurosurgery (n= 48,10.76% ),and the strains were mainly isolated from sputum specimens (94.62% ).Antimicrobial susceptibility testing with 13 kinds of commonly used antimicrobial agents showed that antimicrobial resistance of A.baumanniifrom ICU were highest, susceptibility rates were all<20% ,the next were from department of neurosurgery,susceptibility rates were all<30% ,while susceptibility rates of A.baumanniifrom department of respiratory diseases were all >50% .Conclu-sion The difference in antimicrobial resistance of A.baumanniifrom different wards varied significantly,antimi-crobial resistance of A.baumanniifrom ICU is most serious.

Objective To assess left ventricular radial systolic synchronicity with omnidirectional M-mode echocardiography (OME). Methods OME examination was performed in 21 patients with dilated cardiomyopathy (DCM) and 27 healthy controls. The time to peak radial systolic movement were measured and adjusted by R-R interval. The standard deviation (Tc-SD)and the maximal temporal difference (Tc-dif) of the time to peak radial systolic movement of left ventricular short-axis segments at basal and mid-levels, the septal-to-posterior wall motion delay (SPWMD), septal-to-anterior wall motion delay (SAWMD), septal-to-laterior wall motion delay (SLWMD), septal-to-inferior wall motion delay (SIWMD) and anterior-to-inferior wall motion delay (AIWMD) were used as indicators of systolic dyssynchrony.Results Compared with the controls, Tc-dif, Tc-SD, SLWMD, SPWMD and SIWMD in basal level were significantly higher in the DCM group (P<0.05), while Tc-dif, Tc-SD, SAWMD, SPWMD, SIWMD and AIWMD in mid-level were significantly higher in the DCM group (P<0.05).Conclusion Omnidirectional M-mode echocardiography is useful to evaluate the radial systolic synchrony of the left ventricular in patients with dilated cardiomyopathy.

Advances in the understanding of cancer at the molecular level have led to much progress in the development of anti-cancer agents. Among the newly invented medications for targeted cancer therapy, protein kinase inhibitors target intracellular molecules crucial in signaling pathways for cancer cell survival, proliferation, and disease progression. The Raf serine/threonine kinases are pivotal molecules within the Raf/mitogen extracellular kinase (MEK)/extracellular signal-related kinase (ERK) signaling pathway. The exact function of Raf in normal human cells is not yet understood; however, preclinical and clinical researches have shown that over expression of Raf gene or overreaction of Raf kinase isoforms have critical roles in many types of solid tumors, including renal cell carcinoma, hepatocellular carcinoma, melanoma, and non-small cell lung cancer (NSCLC). Sorafenib is the first oral, multi-kinase inhibitor that targets the Raf kinases. It also has a broad spectrum activity against other receptor tyrosine kinases associated with vascular endothelial growth factor receptors and platelet-derived growth factor receptors. Sorafenib was recently approved by FDA for use in advanced renal cell cancer, and is currently undergoing active investigation in the treatment of other types of malignancies, such as melanoma, liver cancer, prostate cancer, and NSCLC. In this review, we will illustrate the role of Raf in both normal and malignant cells, the mechanism of sorafenib in the treatment of renal cell carcinoma, as well as clinical data that support its use and further investigation in advanced renal cell carcinoma, melanoma, and other tumor types.

ObjectiveTo investigate the feasibility and influence factors of a new silver salt method for determination of arsenic in drinking water. Methods Arsenic was determined at different reaction temperature,acidity, specification and addition of zinc granular, fill weight of lead acetate cotton, and the effect of these factors on assay results was observed. Arsenic in drinking water was determined in accordance with standard test methods (GB/T 5750.6) of the new silver method. Results The recoveries of the arsenic were 75.3％ - 93.6％(F =9.21,P ＜ 0.01 ) with reaction temperature at 10 - 30 ℃, and the best reaction temperature was 25 ℃. The recoveries of the arsenic ranged from 80.3％ - 91.6％(F =4.67, P＜ 0.05) when sulfuric acid was 3.0 - 6.0 ml and the best value was 5.0 ml. The recoveries of the honeycomb structural zinc granular(diameter 0.2 - 0.3, 0.3 - 0.4 mm) and button zinc granular were 87.2％, 90.7％ and 83.0％, respectively; the best specification was 0.3 - 0.4 mm. The recoveries of zinc granular weight(3 - 5 g ) were 74.6％ - 91.7％, respectively; the best was 5 g. The recoveries ranged from 79.6％ - 91.3％ with fill weight of lead acetate cotton at 25 - 100 mg, the best fill weight was 50 mg.The recoveries of the arsenic were 90.7％, 92.5％, 81.5％ and 74.2％ with lead acetate cotton length at 0.5 - 2.0 cm,and the best loose-tight degree was 1.0 cm. The stability time of arsine solution was 5.0, 4.0, 2.5 h with corresponding temperature at 20, 25, 30 ℃, respectively. ConclusionsIn order to ensure precision and accuracy of the measurement, it is necessary to control reaction temperature, acidity, specification and addition of zinc granular free from arsenic, fill weight of lead acetate cotton and loose-tight degree in the reaction system.