OBJECTIVETo explore the curative efficacy of methotrexate(MTX) combined with rituxan for treating patients with primary central nervous system(CNS) lymphoma.

METHODSOne hundred patients with primary CNS lymphoma in our hospital were randomly divided into targeted treatment group(50 cases) and traditional treatment group (50 cases). Targeted treatment group adopted the therapy of high-dose methotrexate combined with rituxan, the traditional treatment group adopted the high-dose methotrexate combined with whole brain radiotherapy. The results of relevant imaging examination, clinical data, imaging, follow-up and the survival time were analysed and compared between these 2 groups.

RESULTSIn the targeted therapy group, there were 33 cases in CR, 9 cases were in stable condition, and 5 cases were in partial response, and 3 cases in the progressive stage. In the group of traditional treatment group, 29 cases reached complete remission, 5 cases were in stable condition, 11 cases were in partial response, and 5 cases were in the progressive stage. In the targeted treatment group and traditional treatment group, the median progression-free survival time was 28 and 11 months, respectively.

CONCLUSIONThe first choice for treatment scheme of PCNSL is high-dose methotrexate chemotherapy combined with whole brain radiotherapy, that showed a certain curative effect, but the adverse reactions are larger, and a big late neuro toxic reaction may occur, while high-dose methotrexate combined PCNSL rituxan treatment shows high curative effect, less adverse reaction and low side effects. This treatment also has a more positive value for the elderly patients with PCNSL.

OBJECTIVE: To investigate the clinical efficacy and Safety of R-CDOP regimen for treatment of newly diagnosed DLBCL patients with adverse prognostic factors. METHODS: The clinical data of 94 patients who suffered from DLBCL and received treatment with R-CDOP regimen, from October 2013 to February 2018 were collected and analyzed retrospectively. The clinical efficacy, survival benifits and safety, as well as the OS and PFS were compared according to clinical features. RESULTS: After treatment of 94 cases with R-CDOP regimen, 73 cases reachived CR, 14 cases reachived PR, 2 cases were in SD and 4 cases were in PD, the ORR was 92.55% (87/94). The OS rate and PFS rate in followed-up 1 year were 94.68%（89/94） and 85.11%（80/94） separately, However, the median OS and PFS were not reached. There was no significant difference in the followed-up cumulative OS rate and PFS rate between patients with different Age, Ann-Arbor stage, IPI score, number of extranodal tumors, tumor diameter, expression of Ki-67 and LDH level and tissue involvement status（P>0.05）. There was no significant difference in the 1 years PFS rate and OS rate between patients with number of extranodal tumors for 0-1 and ≥2（P>0.05）. There was no significant difference in the 1 years PFS rate and OS rate between patients with tumor diameter for <7.5 cm and ≥7.5 cm（P>0.05）. CONCLUSION The R-CDOP regimen in the treatment of newly diagnosed DLBCL patients with poor prognostic factors can efficiently improve the early clinical efficacy, prolong the survival time and possess good safety, but the clinical prognosis for long-term remains to be observed.
Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; Cyclophosphamide ; Disease-Free Survival ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; Prognosis ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To investigate the expression and clinical significance of microRNA-195 in patients with diffuse large B cell lymphoma(DLBCL). METHODS: Sixty patients with DLBCL were selected from nearly four years in our hospital, and at the same time 30 healthy people with physical examination of the same period and with the same age in our hospital were choosed as control group. Real-time fluorescent quantitative PCR (RT-qPCR) was used to detect the miR-195 expression of the patients and controls, the relationship between miR-195 expression and clinicopathological characteristics of DLBCL and survival time of patients was analyzed. RESULTS: The expression level of miR-195 in DLBCL patients was significantly lower than that in the controls (P<0.001). The expression level of miR-195 closely related with tumor diameter, IPI score and Ann Arbor stage of patients with DLBCL. Overall survival(OS) time of DLBCL patients with highly expressed miR-195 was significantly longer than that of patients with low expression (P<0.001). CONCLUSION miR-195 expression decrease in DLBCL patients, and miR-195 closely relates with tumor characteristics of patients with DLBCL. DLBCL patients with higher expression of miR-195 show longer overall survival time.

OBJECTIVE: To investigate the clinicopathological features of intestinal diffuse large B-cell lymphoma (DLBCL). METHODS: The clinical features, pathological morphology, immunophenotype, and EBER in situ hybridization of 136 DLBCL patients diagnosed in Jinan People's Hospital Affiliated to Shandong First Medical University from January 2007 to October 2014 were analyzed retrospectively. A total of 136 DLBCL samples were obtained, the DLBCL sites were categorized as: duodenum (n=23), ileocecal region (n=63), other small intestine (n=29), rectum (n=7), and other large intestine (n=14). Survival curves for the DLBCL patients were plotted using the Kaplan-Meier method and judged by the Log-rank test. RESULTS: Patients with DLBCL of the ileocecal region and other small intestine except duodenum were mainly male (P=0.042), and had a higher proportion of limited-stage tumors(P=0.015), and lower International Prognostic Index (IPI) (P=0.001). Patients with DLBCL of ileocecal region had higher incidence of lactate dehydrogenase elevation (P=0.007), and higher incidence of intestinal obstruction or perforation (P<0.001) than those with DLBCL of other regions. The 5-year overall survival and 5-year progression-free survival of patients with DLBCL in ileocecal and other small intestine sites were higher than those in other sites, but the differences were not statistically significant (P=0.135, 0.459). Fifty percent of intestinal DLBCL were germinal center B cell-like (GCB) subtypes. A low-grade B-cell lymphoma was found in 21% of 136 tumor samples. In ileocecal and other small intestinal specimens, the proportion of low-grade B-cell lymphoma was 29%, and the difference was statistically significant(P=0.025). About 16% of 136 DLBCL samples expressed follicular lymphoma while no mucosa-associated lymphoid tissue lymphoma . The Epstein-Barr virus-encoded RNA-1 (EBER1) positive rate of duodenal DLBCL was significantly higher than that of other sites (5/23, 22% vs 2/63, 3%, P=0.001). CONCLUSION The intestinal DLBCL is commonly observed in male, and ileocecal is the most primary site. Patients with DLBCL of the ileocecal region and small intestine except duodenum have low IPI, high proportion of limited-stage tumors, low level of lactate dehydrogenase, high incidence of intestinal obstruction or perforation, and low incidence of inert lymphoma. The EBER1 positive rate of DLBCL in duodenal is higher.
Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; Humans ; Lymphoma, Large B-Cell, Diffuse ; Male ; Prognosis ; Retrospective Studies

OBJECTIVES: To use virtual anatomy technique in the analysis of post-mortem characteristic changes of CT images in the experimental drowning rabbit model and the related parameters in 3D virtual model, so as to explore its application value in the diagnosis of drowning in forensic pathology. METHODS: A model of drowning rabbits was established, with animal models of hemorrhagic shock and mechanical asphyxia as the controls. CT scan was performed on the experimental animals, and the differences in imaging features between the groups were compared by morphological reading of the tomographic images. CT data were imported into Mimics 14.0 software for 3D modeling. The CT values and lung volumes were calculated by the software, and the differences on CT values and lung volumes brought by different causes of death were analyzed. RESULTS: The CT images of lungs in the drowning group showed characteristic ground-glass opacity （diffuse and uniform density increase）. There were no obvious abnormalities in hemorrhagic shock group, and only a few similar changes were found in the mechanical asphyxia group. Compared with the controls, the CT values and the lung volumes in the drowning group were significantly increased P<0.05. CONCLUSIONS Based on post-mortem lung imaging, the combination of CT value and lung volume changes can effectively reflect the virtual anatomical features in drowning, and provide a diagnostic basis for the forensic identification of drowning.
Animals ; Drowning ; Lung/diagnostic imaging* ; Rabbits ; Tomography, X-Ray Computed

BACKGROUNDThe domestic prevalence of chronic hepatitis B (CHB) in China is 7.18% in 2006, imposing great societal healthcare burdens. Nucleot(s)ide analogues (NUCs) anti-hepatitis B virus (HBV) therapies are widely applied despite the relatively low rate of seroconversion and high risk of drug-resistant mutation. More effective treatments for CHB deserve further explorations. Combined therapy of NUCs plus Chinese herbal medicine (CHM) is widely accepted in China, which is recognized as a prospective alternative approach. The study was primarily designed to confirm the hypothesis that Tiaogan-Yipi Granule (, TGYP) or Tiaogan-Jianpi-Jiedu Granule (, TGJPJD) plus entecavir tablet (ETV) was superior over ETV monotherapy in enhancing HBeAg loss rate.

METHODSThe study was a nationwide, large-scale, multi-center, double-blind, randomized, placebo-controlled trial with a designed duration of 108 weeks. A total of 16 hospitals and 596 eligible Chinese HBeAg positive CHB patients were enrolled from November 2012 to September 2013 and randomly allocated into 2 groups in 1:1 ratio via central randomization system: experimental group (EG) and control group (CG). Subjects in EG received CM formulae (TGYP or TGJPJD, 50 g per dose, twice daily) plus ETV tablet (or ETV placebo) 0.5 mg per day in the first 24 weeks (stage 1), and CHM granule plus ETV tablet (0.5 mg per day) from week 25 to 108 (stage 2). Subjects in CG received CHM Granule placebo plus ETV tablet (0.5 mg per day) for 108 weeks throughout the trial. The assessments of primary outcomes (HBV serum markers and HBV-DNA) were conducted by a third-party College of American Pathologists (CAP) qualified laboratory. Adverse effects were observed in the hospitals of recruitment.

DISCUSSIONThe study was designed to compare the curative effect of CM plus ETV and ETV monotherapy in respect of HBeAg loss, which is recognized by the European Association for the Study of the Liver as "a valuable endpoint". We believe this trial could provide a reliable status for patients' "journey" towards durable responses after treatment discontinuation. The trial was registered before recruitment on Chinese Clinical trial registry (No. ChiCTR-TRC-12002784, Version 1.0, 2015/12/23).