Objective To analyze the clinical characteristics and prognosis of 4 rare types of non -Hodgkin lymphoma(NHL)in children,and to discuss the progress in treatment.Methods Clinical data of 1 4 patients with rare types of NHL at Shanghai Children′s Medical Center,Shanghai Jiaotong University School of Medicine between January 2004 and December 201 4 were retrospectively analyzed,and their clinical features,treatment and prognosis were dis-cussed.Results Fourteen cases were reported including 6 subcutaneous panniculitis -like T -cell lymphoma (SPTCL),3 hydroa vacciniforme -like cutaneous lymphoma(HVLL),2 pediatric follicular lymphoma(PFL)and 3 ex-tranodal NK/T -cell lymphoma,and nasal type(ENKTL).Ten patients (71 .4%)primarily presented with skin lesions and underwent a long course of illness before they were finally diagnosed (the median was 1 0 months),71 .4%(1 0 /1 4 cases)of them associated with fever and 50.0%(7 /1 4 cases)with liver and spleen enlargement,and no evidence of central nervous system (CNS)and bone marrow (BM)involvement was observed,while 28.6% patients (4 /1 4 cases) had more than two lines′abnormalities in peripheral blood examination.Since there were no standard treatment guide-lines,most patients received CHOP (Cyclophosphamide +Adriamycin +Vincristine +Prednisone)and /or mature B -cell NHL -like therapy,and 50.0%(7 /1 4 cases)of them received interferon therapy in addition,while 1 patient re-ceived allogeneic hematopoietic stem cell transplantation after recurrence.The complete remission was achieved in 71 .4%(10 /14 cases)of all the patients.Two of them died,3 lost follow -up,and 1 relapsed.The 3 -year overall survi-val and event free survival rates were 0.84 and 0.57,respectively,after a median follow -up of 26 months (range 12 -64 months).Conclusions Pediatric rare types of NHL show atypical clinical manifestation,low incidence of CNS /BMinfil-tration and long course.It is hard to make pathological diagnosis and differentiation.It is also inappropriate to apply the commonly used staging system to these rare types of NHL.No standard treatment has been found by now.SPTCL,HVLL and PFL have relatively good outcomes when treated with mature B -cell NHL -type therapy plus interferon therapy.

Objective? To systematically analyze the incidence and influencing factors of post-extubation dysphagia (PED) among patients with mechanical ventilation. Methods? Observational studies on PED were systematically retrieved in PubMed, CIHNAL, Cochrane Library, WanFang data, China National Knowledge Infrastructure (CNKI) and VIP. We screened literatures, extracted data and evaluated the literature quality. The Stata14.0 was used to meta-analysis. Results? A total of 1 356 literatures were retrieved and 8 of them were included, 5 literatures on cohort study and 3 on cross-sectional study. Totals of 2 384 research objects were included and 553 of them were with PED. Meta-analysis showed that the incidence of PED was 36% (95% CI: 23%-50%), the rates of PED patients with intubation time ≥48 h and ＜48 h were 46% (95%CI: 40%-53%) and 6% (95%CI: 5%-7%) respectively. The independent influencing factors of PED were the intubation time and ages. Subgroup analysis revealed that the ages(OR=2.18,95%CI:1.42～3.34) was the influencing factor among patients with intubation time ＜48 h, but intubation time could not be determined;the ages (OR=1.02, 95%CI: 1.00-1.05) and intubation time (OR=1.28, 95%CI: 1.08-1.52) were the influencing factors among patients with intubation time ≥48 h. Publication bias analysis showed that the included literatures were with no significant bias and with credible results. Conclusions? We should pay attention to problems existing in PED among patients with mechanical ventilation particularly in patients with intubation time ≥48 h and old ages, so as to promote early detection and early intervention of PED.

Objective To analyze the clinical characteristics and prognosis of rare soft tissue sarcomas.Method Clinical data of 51 patients with rare soft tissue sarcomas including fibrosarcoma,synovial sarcoma,extrarenal rhabdoid tumor,alveolar soft part sarcoma,desmoplastic small round cell tumor and undifferentiated sarcoma in children and adolescents,diagnosed at Shanghai Children's Medical Center from June 1998 to December 2013,were retrospectively analyzed.All types were treated with the same strategy and chemotherapy regimens.Their clinical features,treatment and prognosis were discussed.Result Seventeen patients with fibrosarcoma,10 with synovial sarcoma,9 with extrarenal rhabdoid tumor,6 with alveolar soft part sarcoma,3 with desmoplastic small round cell tumor and 6 with undifferentiated sarcoma were included.The mean age at initial diagnosis was 5 years(range from 1 month to 13.5 years).The most common primary site of tumors was limbs,followed by the thoracic and abdominal cavity,accounting for 41％ and 24％ respectively.Twelve cases presented distant tissue or organ involvement in which bone metastases occupied the first place.Seven cases(accounting for 14％)were at stage Ⅰ,13 cases were at stage Ⅱ (accounting for 25％),19 cases were at stage Ⅲ (accounting for 37％) and 12 cases were at stage Ⅳ (accounting for 24％).The median follow-up period was 36 months(range from 1 month to 123 months).Forty-four patients achieved complete remission and 3 patients achieved partial remission after initial treatment,the overall response rate was 92％.Subsequent follow-up showed 29 patients remained relapse-free while 13 patients had relapsed disease.Overall survival and event-free survival at 2 years were 88％ and 57％.Postoperative surgical staging was the main prognostic factors.Patients with stage Ⅲ + Ⅳ had poorer results than those with Ⅰ + Ⅱ (x2 =4.909,P =0.027).Conclusion These 6 types of soft tissue sarcomas are rare in children and adolescents.The tumor can occur anywhere in the body but commonly presents in the extremities.Complete resection of tumor remains the most important modality of treatment and is directly related to prognosis.Neoadjuvant chemotherapy helps improve the resection rate of some unresectable tumors at diagnosis.Radiation therapy is primarily adopted for focal tumor control.

Prostate cancer is the most common cancer among men and the fifth leading cause of cancer-related death among men worldwide. Gastrin-releasing peptide receptor (GRPR) is an important complementary target of prostate specific membrane antigen (PSMA) and a key target for prostate cancer diagnosis and treatment. Radionuclide labeled bombesin (BBN) analogues can accurately target overexpressed GRPR in tumor cells, thus providing early diagnosis and treatment of prostate cancer. In this review, we focus on the studies of 99Tc m, 111In, 68Ga, 64Cu, 18F, and 177Lu nuclide-labeled BBN analogues for diagnosis and peptide receptor radionuclide therapy.