Peripheral T-cell lymphoma (PTCL) is a kind of highly aggressive lymphoma which contains a collection of subgroups. The patients with PTCL have poor prognosis under current chemotherapy regimens, so the treatment of PTCL remains a big challenge. Brentuximab vedotin combined with CHP regimen, pralatrexate in combination with romidepsin and other regimens have set up more options for patients with PTCL. Novel agents, such as PI3K inhibitors, which entered into clinical trials, bring good news to PTCL patients.

Objective To construct a Nomogram prediction model based on body position exer-cise training for patients with chronic constipation.Methods A total of 327 patients with chronic constipation from March 2021 to March 2023 were divided into qualified group(n=279)and unqual-ified group(n=48)according to their performance in body position exercises.General clinical mate-rials of the patients were collected,and univariate and multivariate Logistic regression analyses were performed to identify risk factors for unqualified body position exercises in patients with chronic con-stipation;the R software was used to construct a Nomogram model for predicting unqualified body po-sition exercises in patients with chronic constipation,and the receiver operating characteristic(ROC)curve and calibration curve were applied to verify the discrimination and consistency of the Nomogram model.Results There were no significant differences in gender,education level,history of smok-ing,history of alcohol abuse,history of hypertension,history of abdominal surgery,history of colonoscopy,and correct medication administration ratio between the two groups(P＞0.05);the un-qualified group had higher age,longer duration of chronic constipation,and a higher proportion of di-abetes history compared to the qualified group(P＜0.05);age,duration of chronic constipation,and diabetes history were independent risk factors for unqualified body position exercises in patients with chronic constipation(P＜0.05).The constructed Nomogram prediction model demonstrated excellent discrimination(area under the curve was0.923,95％CI,0.888 to 0.949,with sensitivity and specificity of 87.50％and 81.00％respectively)and consistency(H-L goodness-of-fit test x2=2.246,P=0.973).The clinical value of this Nomogram model in predicting unqualified body posi-tion exercises for patients with chronic constipation was high when the high-risk threshold probability ranged from 0.06 to 0.80.Conclusion Age,duration of chronic constipation,and diabetes history are independent risk factors for unqualified body position exercises in patients with chronic constipa-tion,and the Nomogram model constructed based on these multi-factor results has high discrimination and consistency in predicting unqualified body position exercises for patients with chronic constipation.

Objective To construct a Nomogram prediction model based on body position exer-cise training for patients with chronic constipation.Methods A total of 327 patients with chronic constipation from March 2021 to March 2023 were divided into qualified group(n=279)and unqual-ified group(n=48)according to their performance in body position exercises.General clinical mate-rials of the patients were collected,and univariate and multivariate Logistic regression analyses were performed to identify risk factors for unqualified body position exercises in patients with chronic con-stipation;the R software was used to construct a Nomogram model for predicting unqualified body po-sition exercises in patients with chronic constipation,and the receiver operating characteristic(ROC)curve and calibration curve were applied to verify the discrimination and consistency of the Nomogram model.Results There were no significant differences in gender,education level,history of smok-ing,history of alcohol abuse,history of hypertension,history of abdominal surgery,history of colonoscopy,and correct medication administration ratio between the two groups(P＞0.05);the un-qualified group had higher age,longer duration of chronic constipation,and a higher proportion of di-abetes history compared to the qualified group(P＜0.05);age,duration of chronic constipation,and diabetes history were independent risk factors for unqualified body position exercises in patients with chronic constipation(P＜0.05).The constructed Nomogram prediction model demonstrated excellent discrimination(area under the curve was0.923,95％CI,0.888 to 0.949,with sensitivity and specificity of 87.50％and 81.00％respectively)and consistency(H-L goodness-of-fit test x2=2.246,P=0.973).The clinical value of this Nomogram model in predicting unqualified body posi-tion exercises for patients with chronic constipation was high when the high-risk threshold probability ranged from 0.06 to 0.80.Conclusion Age,duration of chronic constipation,and diabetes history are independent risk factors for unqualified body position exercises in patients with chronic constipa-tion,and the Nomogram model constructed based on these multi-factor results has high discrimination and consistency in predicting unqualified body position exercises for patients with chronic constipation.

To assess relationships between xanthine oxidase (XOD) and nephropathogenic infectious bronchitis virus (NIBV) infection, 240 growing layers (35 days old) were randomly divided into two groups (infected and control) of 120 chickens each. Each chicken in the control and infected group was intranasally inoculated with 0.2 mL sterile physiological saline and virus, respectively, after which serum antioxidant parameters and renal XOD mRNA expression in growing layers were evaluated at 8, 15 and 22 days post-inoculation (dpi). The results showed that serum glutathione peroxidase and superoxide dismutase activities in the infected group were significantly lower than in the control group at 8 and 15 dpi (p < 0.01), while serum malondialdehyde concentrations were significantly higher (p < 0.01). The serum uric acid was significantly higher than that of the control group at 15 dpi (p < 0.01). In addition, the kidney mRNA transcript level and serum activity of XOD in the infected group was significantly higher than that of the control group at 8, 15 and 22 dpi (p < 0.05). The results indicated that NIBV infection could cause the increases of renal XOD gene transcription and serum XOD activity, leading to hyperuricemia and reduction of antioxidants in the body.
Antioxidants ; Chickens ; Glutathione Peroxidase ; Hyperuricemia ; Infectious bronchitis virus* ; Kidney ; Malondialdehyde ; RNA, Messenger* ; Superoxide Dismutase ; Uric Acid ; Xanthine Oxidase* ; Xanthine*

Hodgkin lymphoma (HL) is a highly curable malignancy for most patients, while the treatment of relapsed and refractory HL is still a difficult and important field. A high dose of chemotherapy with autologous stem cell transplantation is treated as the preferred treatment with a high relapse incidence. The 59th American Society of Hematology Annual Meeting reported the recent progress of the treatment of relapsed and refractory HL, including the improvement of traditional high dose chemotherapy regimens, the new drugs or therapies like brentuximab vedotin, nivolumab, pembrolizumab and ibrutinib, and chimeric antigen receptor T-cell. This review focuses on these advances.

Objective: To evaluate the prognostic value of lymphocyte-to-monocyte ratio (LMR) in angioimmunoblastic T cell lymphoma (AITL). Methods: Data of 64 patients diagnosed as AITL at the First Affiliated Hospital of Nanjing Medical University between June 2009 and July 2017, were analyzed retrospectively. Receiver Operator Characteristic (ROC) curve was used to calculate the cutoff value of LMR to divide this cohort of patients into high and low LMR groups. Characteristics between groups were compared by Pearson Chi-square or Fisher exact tests. Kaplan-Meier method and Cox regression were performed to probe prognostic factors associated with progression-free survival (PFS) and overall survival (OS). Results: A total of 64 cases [39 cases male and 25 ones female with the median age of 63 (29-89) years old] were enrolled. The cutoff value of LMR was 3.07. Patients with low LMR showed inferior PFS (9 months vs 13 months, P=0.044) and OS (16 months vs not reached, P=0.014), respectively than those without low LMR during a median follow-up of 33 months (5 to 103 months). Multivariate analysis showed that low LMR was an independent prognostic factor associated with poor outcomes (HR=0.48, 95% CI 0.26-0.92 for PFS, P=0.027; HR=0.38, 95% CI 0.18-0.82 for OS, P=0.013, respectively). Subgroup analysis showed that patients with low LMR and under the situation of high score of Prognostic Index for peripheral T-cell lymphoma, Unspecified (PIT) (2-4) had shorter PFS and OS (P=0.013 and P=0.031, respectively). But in low score of PIT (0-1) group, low LMR seemed to play almost no effects on PFS and OS (P=0.949 and P=0.238, respectively). Conclusions The disease risk status of patients could be initially assessed according to PIT score and LMR level. Low LMR was demonstrated to be able to predict poor outcome in AITL.

Objective: To analyze the clinical characteristics, treatment and prognosis of primary gastric lymphomas (PGL). Methods: A retrospective study was conducted in 124 cases of PGL from July 2009 to January 2016 in our hospital, and the clinical records, pathological and immunohistochemical features were analyzed. The relationship between different factors at diagnosis and prognosis were studied. Results: 124 cases of PGL included 93 diffuse large B cell lymphoma (DLBCL) patients, 25 mucosa associated lymphoid tissue (MALT) lymphoma cases, 1 mantle cell lymphoma, 4 peripheral T-cell lymphoma-not otherwise specified, and 1 extra-nodal NK/T-cell lymphoma-nasal type. Of the 93 primary gastric DLBCL (PG-DLBCL) patients, the germinal center B cell-like (GCB) DLBCL were 45 cases, non-GCB DLBCL were 48 cases. 10 cases (10.8%) of 93 PG-DLBCL were transformed from gastric MALT, and 7 cases (7.5%) have bone marrow involvement. Evidence of Helicobacter pylori infection was detected in 21 cases (51.2%) of 41 DLBCL patients and in 10 cases (43.5%) of 23 MALT patients. Univariate analysis revealed that clinical stages (P=0.002) , B symptoms (P=0.001) , international prognostic index (IPI) score (P<0.001) , anemia (P<0.001) , low level of serum albumin level (P=0.001) , high level of lactate dehydrogenase (LDH) (P<0.001) , high β2-microglobulin (P=0.003) , chemotherapy uncombined with rituximab (P=0.006) were factors affecting progression-free survival (PFS). Multivariate Cox regression analysis indicated that clinical stages (HR=5.113, 95% CI 1.087-24.048, P=0.039) and LDH (HR=5.111, 95%CI 1.651-15.827, P=0.005) were independent poor prognosis factors affecting PFS. In the non-GCB group, the PFS was significantly extended (P=0.013) , the OS has no statistical significance (P=0.764). The PFS was significantly shortened in MALT transformed to DLBCL compared with MALT lymphoma patients (P=0.016) , but have no statistical significance compared with DLBCL patients (P=0.373). Conclusions The types of DLBCL and MALT are more common in PGL. PG-DLBCL is a highly heterogeneous malignant tumor, and advanced clinical stages and high LDH value are associated with poor outcome.

Objective: To investigate whether high-dose methylprednisolone with Rituximab and fresh frozen plasma (HDMP+RTX+FFP) is an effective therapy for patients with B-cell chronic lymphoproliferative disorders (B-CLPD) with TP53 abnormalities. Methods: Six B-CLPD patients with TP53 abnormalities from May 2008 to May 2012 were prospectively enrolled in the study. The patients were treated with HDMP+RTX+FFP for up to 6 cycles. Results: Of the six B-CLPD patients, there were 4 cases of chronic B-cell lymphoproliferative disorders-unclassified (B-CLPD-U) , 1 B-cell prolymphocytic leukemia (B-PLL) and 1 mantle cell lymphoma (MCL) . After a median 3 courses of treatment, 4 patients achieved complete remission (CR) including 3 with undetectable minimal residual disease (MRD^-) . One patient was evaluated as stable disease (SD) and another one patient was in disease progression (PD) . After a median follow-up of 30 (4-56) months, 2 non-responders progressed quickly and died. All of CR patients survived and no one succumbed to disease progression at the last follow-up. The hematopoietic function was significantly improved after the treatment whereas there was also significant decrease in serum IgA, IgG and IgM levels. All patients showed well tolerance to this regimen. The incidence of myelosuppression was low and adverse events (AE) were mainly neutropenia which did not exceed grade 3 and infection. All AE were controllable. Conclusion HDMP+RTX+FFP is an effective and relatively tolerable therapy for patients with B-CLPD accompanying with TP53 abnormalities.

Objective: To investigate the characteristics in pathological diagnosis, clinical features, treatment and prognosis of adult patients with pediatric-type follicular lymphoma (PTFL) . Methods: The clinical and pathological features, laboratory examination, diagnosis and treatment, follow-up results of 5 adult PTFL patients admitted in Jiangsu Province Hospital were retrospectively analyzed, and literature review was conducted in combination with related reports. Results: All 5 patients developed PTFL in their adulthood with a median age of 22 years old (15-33 years) . The initial inanifestation of the disease was local painless lymphadenopathy with no fever, night sweats, emaciation or other systemic B symptoms. Pathological characteristics including typical large follicular structures and high proliferation index were found. Meanwhile, additional clonal rearrangement of immunoglobulin heavy chain gene was observed. However, there was no BCL-2 expression in histochemistry as well as BCL-2 gene abnormality in fluorescence in situ hybridization among these PTFL patients. These adult PTFL patients were all in stage Ⅰ-Ⅱ of the disease. For treatment, they were only treated with local surgical excision after diagnosis while didn’t receive subsequent local radiotherapy or systemic immunochemotherapy. During a median follow-up of 27 months, the 5 cases of PTFL kept in a state of sustained complete remission. Conclusion Adult-onset PTFL is characterized by high pathological proliferation index, while no BCL-2 expression or BCL-2 gene abnormality. Besides, PTFL is clinically manifested as a localized disease that can achieve a quite good prognosis through local surgical intervention. The aforementioned attributes of PTFL are distinctly different from classic adult follicular lymphoma.

OBJECTIVE: To analyze the correlation between the mutational status of immunoglobulin heavy chain variable (IGHV) gene with the prognosis of patients with Waldenström macroglobulinemia (WM). METHODS: Immunoglobulin heavy chain gene (IGH) clonotypic sequence analysis was carried out to assess the mutational status of IGHV in the blood and/or bone marrow samples from 44 WM patients. The usage characteristics of IGHV-IGHD-IGHJ gene was explored. RESULTS: The most common IGHV subgroup was IGHV3, which was similar to the data from the Institute of Hematology of Chinese Academy of Medical Science. IGHV3-23 (20.45% vs. 15.44%) and IGHV3-74 (11.36% vs. 7.35%) were the main fragments used, which was followed by IGHV4 gene family (15.91% vs. 24.26%). However, no significant correlation was found between the IGHV4 usage and the prognosis of the patients. Should 98% be taken as the cut-off value for the IGHV mutation status, only 5 patients had no IGHV variant, and there was no correlation with the prognosis. Based on the X-tile analysis, 92.6% was re-selected as the cut-off value for the IGHV variant status in such patients. LDH was increased in 26 patients (59.1%) without IGHV variant (P < 0.05), whilst progression-free survival (P < 0.05) and overall survival (P < 0.05) were significantly shorter compared with those with IGHV variants. CONCLUSION The usage characteristics of IGHV-IGHD-IGHJ in our patients was similar to reported by the Institute of Hematology of Chinese Academy of Medical Science, albeit that no correlation was found between the IGHV4 usage and the prognosis of the patients. Furthermore, 98% may not be appropriate for distinguishing the IGHV variant status in WM patients.
Humans ; Immunoglobulin Heavy Chains/genetics* ; Multigene Family ; Mutation ; Waldenstrom Macroglobulinemia/genetics*