Mucosa-associated lymphoid tissue lymphomas are a distinct subgroup of non-Hodgin's lymphoma with a particular clinicopathologic behavior.It is the most common type of extranodal low-grade B cell lymphoma.This type of lymphoma tends to appear in patients with a history of autoimmune disease or chronic inflammatory disorders.These indolent lesions usually remain localized for long periods and often respond to local therapy.The most common site of MALT lymphoma is the stomach.This article reviews clinical features and management of MALT lymphoma,emphasizing on gastric MALT lymphoma.

Objective To investigate the application of pediatric early warning score (PEWS) in neurology department.Methods The clinical data and PEWS of 1,158 children with neurologic diseases (764 febrile seizures,259 viral encephalitis and 135 bacterial meningitis) admitted into neurology department from August 2013 to November 2016 were analyzed retrospectively.PEWS was compared among the three different diseases.According to the disease severity,cases were categorized into no-monitor-required group (n =996,697 febrile seizures,203 viral encephalitis and 96 bacterial meningitis),monitor-required group (n =138,67 febrile seizures,41 viral encephalitis and 30 bacterial meningitis) and PICU group (n =24,0 febrile seizures,15 viral encephalitis and 9 bacterial meningitis).PEWS was assessed at admission in both no-monitor-required group and monitorrequired group.PEWS was recorded 12 hours before PICU transfer in PICU group.Then PEWS was compared among all groups in different diseases respectively.Results The median (minimum ～ maximum) of PEWS in febrile seizures,viral encephalitis and bacterial meningitis was 0 (0 ～ 3),2(0 ～ 8) and 2(0 ～ 8),respectively and there was significant difference among three diseases (P ＜ 0.01).No patient of febrile seizures was transferred to PICU.PEWS of febrile seizures in monitor-required group was higher than that in no-monitor-required group (P ＜ 0.01).For both viral encephalitis and bacterial meningitis,PEWS in monitor-required group was higher than that in no-monitorrequired group,and the score in PICU group was higher than that in monitor-required group.The difference was significant (P ＜ 0.01).Conclusion PEWS is effective for the assessment of illness severity of hospitalized children in neurology department,and can be used for the prediction PICU transfer as an excellent screening tool.

Aim To investigate the effect of p38 MAPK AS-ODNs on the expression of GLT-1 during the induction of brain ischemic tolerance induced by cerebral ischemic preconditioning (CIP).Methods Eighty healthy male Wistar rats with permanent occlusion of the bilateral vertebral arteries were randomly divided into 6 groups: ①Sham group (n=10);②CIP group (n=10);③ischemic insult (Ⅱ) group (n=10);④CIP+Ⅱ group (n=10);⑤p38 MAPK AS-ODNs+CIP+Ⅱ group (n=30);⑥p38 MAPK S-ODNs+CIP+Ⅱ group (n=10).Group ⑤ was divided into 5 nmol, 10 nmol and 15 nmol subgroups according to the dose of p38 MAPK AS-ODNs (n=10).The dose of p38 MAPK S-ODNs was 15 nmol.All the rats were sacrificed 6 h and 2 d after the sham operation or the last time of global brain ischemia reperfusion.Western blot and immunohistochemistry analysis were used for detecting the expression of p-p38 MAPK and GLT-1 protein.Results CIP moderately up-regulated the expression of p-p38 MAPK and significantly up-regulated the expression of GLT-1 protein, inhibited the excessively up-regulation of p-p38 MAPK and the down-regulation of GLT-1 induced by ischemic insult.p38 MAPK AS-ODNs significantly inhibited the up-regulation of p-p38 MAPK and GLT-1 protein in a dose-dependent manner during the induction of brain ischemic tolerance by CIP.Conclusion p38 MAPK AS-ODNs inhibit the up-regulation of GLT-1 during the induction of brain ischemic tolerance induced by CIP.

OBJECTIVE: To explore new methods for laparoscopic repair of vesicovaginal fistula. METHODS: Five patients with vesicovaginal fistula in Xiangya Hospital, Central South University, were reviewed retrospectively from May 2013 to July 2014. All patients underwent laparoscopic repair surgery, and the surgical methods were analyzed. The operative time, intraoperative blood loss, and hospital stay time were recorded. The duration of follow-up was from 4 to 12 months. RESULTS: Th e surgical procedures for all 5 patients were successful. No open surgery was required. The operative time was 70~120 (mean: 97) min, the intraoperative blood loss was 40~70 (mean: 54) mL, the hospital stay time was 4~8 (mean: 5.8) days. During the follow up of 4~12 (mean: 7.6) months, no recurrence was observed. CONCLUSION Laparoscopic repair of vesicovaginal fistula is a feasible and safe and effective procedure with less blood loss and shorter recovery time, which can minimize surgery damage and improve successful rate.
Blood Loss, Surgical ; Female ; Humans ; Laparoscopy ; Length of Stay ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Vesicovaginal Fistula ; surgery

Objective To investigate the clinical features of papillary thyroid microcarcinoma(PTMC) and the risk factors of central lymph node metastasis (CLNM) in PTMC patients.Methods The clinical data of 855 patients with PTMC who underwent prophylactic central lymph node dissection were retrospectively reviewed.Results In the present study,the rate of CLNM was 21.9％ (187/855) in PTMC patients.In the univariate analysis,the incidence of CLNM was significantly higher in male patients,age ＜ 45 years,tumor size ＞ 5 mm,capsular invasion,multiple tumor and intracapsular spread (31.4 ％ vs.19.5 ％,x2 =11.429,P =0.001;29.3 ％ vs.15.9 ％,x2 =22.416,P =0.000;30.0％ vs.14.3％,x2 =30.669,P=0.000;29.4％ vs.16.8％,x2 =19.233,P =0.000;30.0％ vs.19.9％,x2 =8.205,P =0.004;42.9％ vs.21.3 ％,x2 =5.549,P =0.018,respectively).Multivariate analysis showed that male gender,age ＜ 45 years,tumor size ＞ 5mm,multiplicity and capsular invasion were independent risk factors for CLNM in PTMC patients (95％ CI:0.380-0.834,0.349-0.693,1.450-3.060,1.078-2.229,1.024-2.373,respectively).Conclusion A routine prophylactic central lymph node dissection should be considered particularly in male PTMC patients with age ＜45 years,tumor size ＞5 mm,capsular invasion and tumor multiplicity.

BACKGROUNDTo summarize the preliminary experience on Iressa for refractory non-small cell lung cancer (NSCLC).

METHODSFifty-five patients with NSCLC, who failed after surgery, radiotherapy, chemotherapy or combination of the above modalities, were registered in this clinical trail. Prior to Iressa, 50 patients were in stage IV, and 5 in stage III. Iressa was administered orally at 250 mg, once a day until cancer progressed or severe toxicity occured, which made patients intolerable. The median time for administration of Iressa was 4 months.

RESULTSThe toxicity of Iressa was tolerable with 47% of skin toxicity (rash) and 2%-7% of diarrhea, nausea, orally mucosal ulceration and alopecia. Overall response rate was 20%. Different sites of distant metastases responded to Iressa in different ways with higher response rate for pulmonary disseminations. One quarter of patients felt improvement of their symptoms over 2 weeks. Median survival time for entire group was 5 months (1-17 months). Median time to progression (TTP) was 3.6 months. Survival at 6 months was 67%. Prognostic predictor, which could imply the outcome, was skin toxicity with higher response rate and longer survival time ( P < 0.05), and no relationship with sex, histological types of NSCLC and distant metastasis had been found.

CONCLUSIONSIressa could be tolerated by refractory NSCLC patients with acceptable side-effects, and have palliative effects.

Histiocytic necrotic lymphadenitis is known as Kikuchi-Fujimoto disease (KFD).KFD is a systemic disease,which is characterized by fever,necrotizing lymphadenopathy and leukopenia.However,involvement of the central and peripheral nervous system is rare.It can present as aseptic meningitis,encephalomyelitis,peripheral neuropathy,cerebellar ataxia and tremor,which makes it difficult to be differentiated with other nervous system diseases.Our review summarizes the clinical manifestations and differential diagnoses of KFD involving nervous system in order to reduce misdiagnoses and mistreatments.

Objective To investigate the prognosis relevant factors of laryngeal squamous cell carcinoma (LSCC).Methods From January 2013 to December 2013,the clinical data of 71 patients with LSCC who were initially treated in Zhejiang Cancer Hospital were retrospectively analyzed.Results Univariate analysis showed that there were statistically significant differences in survival rate between the group of supraglottic type and glottic type (60.0% vs.86.3% ,χ2 =6.284,P<0.05),the group of N0 and N+(41.7% vs.86.4% ,χ2 =16.803,P<0.01), the group of early and late stage(93.6% vs.50.0% ,χ2 =19.854,P<0.01).There were no statistically significant differences in survival rate between the group of age ≤50,>50-60,>60-70 and >70(88.9% vs.88.2% vs. 79.3% vs.62.5% ,χ2 =3.909,P>0.05),the group of T1+T2 and T3+T4(83.6% vs.62.5% ,χ2 =3.623,P>0.05),the group of high,medium,low differentiated and unsigned(75.0% vs.69.7% vs.83.3% vs.91.7% ,χ2 =3.780,P>0.05),the group of surgery,radiotherapy and surgery+radiotherapy (74.3% vs.90.9% vs.71.4% , χ2 =2.437,P>0.05).Multivariate analysis showed that age( P =0.003),treatment( P =0.048) had significant effect on the prognosis of patients,but tumor location(P=0.766),T stage(P=0.677),N stage(P=0.482),clinical stage(P=0.825),the degree of pathological differentiation(P=0.206) had no significant effect on the prognosis of patients.Conclusion More aggressive treatment should be supplied for patients with N+,advanced clinical stage and age whom the prognosis are usually poor. In addition, the proportion of tracheal tube extraction should be appreciated.

Objective To investigate the possible associations of two polymorphisms (5-HTTLPR and STin2VNTR)of the serotonin transporter gene with alcohol use disorders (AUD).Methods 281 AUD cases (AUDIT score≥ 10) and 277 healthy controls (AUDIT score ≤5) were recruited in this study.All participants were genotyped using the PCR technique.Results The frequency of the L-allele of the 5-HTTLPR was 39.01％,and the 10-allele of STin2VNTR was 8.42％ in this population,the allele frequencies of both polymorphisms were consistent with Asian normal populations.No significant association was observed between 5-HTTLPR and AUD,but the genotypic and allele frequencies of the STin2VNTR were significant different between two groups even after Bonferroni adjustment,the 12 repeat allele of the STin2VNTR was significantly associated with the risk effect for AUD.Haplotype analysis for those two polymorphisms revealed no association between 4 haplotype combinations and AUD.Conclusion There is no relationship between 5-HTTLPR and AUD.The STin2VNTR polymorphism of 5-HTT may play a role in the pathogenesis of AUD.

Objective To determine the effects of delayed umbilical cord clamping on the postpartum hemorrhage,instant and long-term newborn anemia,newborn jaundice.Methods In total,303 infants were selected during October 2016 to June 2017 in three hospitals in Beijing.They were randomly allocated into two groups receiving instant clamping of umbilical cord (less than 60s after delivery,n=158) and delayed clamping of umbilical cord(after cord pulsation ceased,n=145).Relevant indicators of maternal and neonatal outcomes are compared.Results There were significant differences between two groups in instant hemoglobin concentration and in 5～7 days (P＜0.05).There were no differences between two groups in transcutaneous bilirubin,the risk of anemia in three months,the risk of jaundice in 5～7 days and the need of blue-light therapy (P＞0.05).There were no differences between two groups of women in postpartum hemorrhage,the length of third stage of labor and the rate of breast feeding (P＞0.05).Conclusion Clamping the umbilical cord when cord pulsation has ceased does not have negative effects on delivery process and postpartum hemorrhage,but it increases the instant hemoglobin concentration and hemoglobin concentration after delivery in 5～7 days.Still it is unclear whether it will affect the risk of jaundice.