A 27-year-old woman was admitted to a hospital due to intermittent fever for 20+ days and swelling pain in knee joint for 7 days.Patients was with persistent fever,the highest temperature to 40.1°C,the double knee joint swelling pain,a large number of scattered red needle-like rash were visible on bilateral hands and legs,lymph-adenectasis,splenectasis,bilateral hands interphalangeal joint and knee joint swelling pain,lymph nodes were con-fined to the bilateral axillary with soft texture,local tenderness,and good activity.Pathological results of left axil-lary lymph node showed the following finding:fragmental lymph node tissue with incomplete structure,lymphoid follicles existed,there were diffuse histocytes,immunoblasts,and a few small lymphocytes proliferation in the re-duced or disappeared area of follicular,caryokinesis could be easily seen,there were patches of necrosis foci with varied size,nucleus disintegrated,fibrinoid necrosis blood vessel with bleeding could be seen.Immunohistochemical detection showed the following results:CD3 (diffuse +);CD20 (follicular +);CD79α(follicular +);CD68 (+);EMA (-);ALK (-);CD15 (a small amount of cells +);CD30 (+),CD4 (-),CD5 (+);CD10 (-);bcl-2 (+);CD21 (+);telomerase B (-);TIA-1 (-);EBV(-)Ki-67 (+).Through a combination of clinical and immunohistochemical detection results,the diagnosis of histiocytic necrotizing lymphadenitis was made.Patient discontinued antimicrobial drugs,after she was treated with 5% glucose 100 mL + hydrocortisone sodium succinate 200 mg intravenous drip for 3 days,patients had no fever,axillary lymph node gradually dwindled.Then patients was treated with methylprednisolone 8 mg/d,twice a day,reduced 1 tablet every two weeks,and stopped eventual-ly.Patients was followed up for two years,repeated examination of blood routine,liver and kidney function were in the normal range,bilateral knee didn’t swell,could walk freely,there appeared no enlargement of lymph node.

The prevalence of liver and intestinal fluke infections was determined by surveying inhabitants of Hengxuan, Fusui, and Shanglin villages which were known to be endemic for liver flukes in Guangxi, China in May 2010. A total of 718 people were examined for helminth eggs by the Kato-Katz thick smear technique, ultrasonography, immunoaffinity chromatography, and DNA sequencing. The overall egg positive rate was found to be 59.6% (28.0-70.6%) that included mixed infections with liver and intestinal flukes. Cases showing higher than 20,000 eggs per gram of feces (EPG) were detected between 1.3% and 16.2%. Ultrasonographic findings exhibited overall 28.2% (72 of 255 cases) dilatation rate of the intrahepatic bile duct. Clonorchis sinensis infection was detected serologically in 88.3% (38 of 43 cases) among C. sinensis egg positive subjects by the immunoaffinity chromatography using a specific antigen for C. sinensis. For differential diagnosis of the liver and intestinal flukes, more precise PCR and nucleotide sequencing for copro-DNA were performed for 46 egg positive cases. Mixed infections with C. sinensis and Metagonimus yokogawai were detected in 8 of 46 egg positive cases, whereas 29 specimens were positive for Haplorchis taichui. Ultrasonographic findings and immunoaffinity chromatography results showed usefulness, even in a limited way, in figuring out of the liver fluke endemicity.
Animals ; China/epidemiology ; Chromatography, Affinity ; Clonorchiasis/*epidemiology/parasitology/ultrasonography ; Clonorchis sinensis/genetics/immunology/*isolation & purification ; Coinfection ; DNA, Helminth/chemistry/genetics ; Feces/parasitology ; Female ; Heterophyidae/genetics/*isolation & purification ; Humans ; Intestines/*parasitology ; Liver/*parasitology ; Parasite Egg Count ; Polymerase Chain Reaction ; Prevalence ; Sequence Analysis, DNA ; Trematode Infections/*epidemiology/parasitology/ultrasonography

Objective:To investigate the safety, efficacy and survival of brentuximab vedotin (BV) monotherapy and BV combined with chemotherapy for relapsed or refractory lymphoma.Methods:A total of 47 patients with relapsed or refractory Hodgkin's lymphoma (HL) in First Medical Center of PLA general Hospital and Fourth Medical Center of PLA General Hospital from October 2011 to December 2018 were admitted, including 35 cases (BV monotherapy group) and 12 cases (BV combined with chemotherapy group); there were 8 cases of relapsed or refractory anaplastic large cell lymphoma (ALCL), 4 cases in BV monotherapy group and 4 cases in BV combined with chemotherapy group. The safety, clinical efficacy and survival of two neoplasms in different groups were compared.Results:For relapsed or refractory HL, the objective remission rate (ORR) and complete remission rate (CRR) was 67.7% (21/31) and 16.1% (5/31), and the median progressive-free survival (PFS) time was 3.5 months (1.5-24.0 months) in BV monotherapy group; ORR and CRR was 81.8% (9/11) and 27.3% (3/11), and median PFS time was 5.5 months (2.0 - 24.0 months) in BV combined with chemotherapy group; there was no statistical difference in ORR and CRR between the both groups (χ 2 = 0.788, P = 0.375; χ 2 = 0.654, P = 0.419). There were 4 cases in BV monotherapy group for ALCL, of which 3 could be evaluated for efficacy, including 1 case of complete remission (CR) and 1 case of partial remission (PR); there were 4 cases in BV combined with chemotherapy group for ALCL, of which 4 could be evaluated for efficacy, including 2 cases of CR and 2 cases of PR. The common adverse events in BV monotherapy group were anemia, leukopenia, thrombocytopenia, fever, elevated transaminase, fatigue, nausea, peripheral neuritis and cough. Grade ≥3 adverse events were mainly anemia, thrombocytopenia and leukopenia. The common adverse events of BV combined with chemotherapy group were similar to those of BV monotherapy group, and there were significant differences in bone marrow suppression (thrombocytopenia, leukopenia) between the two groups (all P < 0.05). Conclusions:The clinical efficacy of BV combined with chemotherapy is better than that of BV monotherapy in treatment of relapsed or refractory lymphoma, and the survival time is prolonged. The adverse reaction of BV combined with chemotherapy is mainly manifested in bone marrow suppression, and the safety and tolerability of patients are acceptable.