Intravascular large B cell lymphoma is a rare subtype of diffuse large B cell lymphoma. Abnormal proliferation of intravascular lymphoma cells is its pathological feature with aggressive clinical behavior such as easy invasive feature, rapid disease progression, poor prognosis and low survival rate. We review the progress in recent research on classification, diagnosis, treatment and prognosis of intravascular large B cell lymphoma.

Objective:To systematically evaluate the efficacy and safety of demethylation drugs intreatment of myelodysplastic syndrome (MDS), and to provide reliable basis and guidance for clinical application of these drugs.Methods:The randomized controlled trials (RCT) of demethylation drugs for treatment of MDS published in the PubMed, Web of Science, Embase, Cochrane Library, Chinese Journal Full-text Database (CNKI), Chinese Biomedical Literature Database (CBM) and VIP database from January 2000 to December 2019 were searched by computer. RevMan 5.3 software was used for Meta-analysis of the efficacy and safety.Results:Seven RCT studies involving 1 172 patients were obtained. Meta-analysis showed that the complete remission rate ( OR = 6.26, 95% CI 1.74-22.49, P = 0.005), partial remission rate ( OR = 4.65, 95% CI 1.51-14.29, P = 0.007), overall response rate ( OR = 14.14, 95% CI 7.27-27.51, P < 0.01), hematology improves ( OR = 3.47, 95% CI 1.44-8.32, P = 0.005) in the demethylation drug treatment group were better than those in the best supportive treatment group. Meanwhile, the overall survival of patients in azacytidine group was improved ( HR = 0.62, 95% CI 0.50-0.77, P < 0.01). In terms of adverse reactions, demethylation drugs increased the incidence of neutropenic fever ( OR = 4.19, 95% CI 2.26-7.76, P < 0.01). However, there was no significant difference in the incidence of neutropenia, thrombocytopenia, anemia, infection, nausea, liver damage and fatigue between the two groups (all P > 0.05). Conclusions:The effect of demethylation drugs in treatment of MDS is obvious, the remission rate can be improved, and azacytidine can prolong the patients' survival, but demethylation drugs increase the incidence of neutropenia fever. In the clinical application of demethylation drugs, it is necessary to further carefully evaluate their clinical safety.

Objective To explore the efficient, cheaper and practical water treatment process in removing algae toxins. Methods The different water treatment methods were used and the optimal combination was selected. The removing efficiency for different processes was compared and validated by beaker test. The enzyme-linked immunosorbent assay (ELISA) was conducted in microcystin testing. Results Coagulating sedimentation could remove a small part of microcystin (removing efficiency was from 4.3% to 29.7% ). When oxidants were applied in pretreatment processes, such as ozone combined with coagulant, 83.3% to 91.9% microcystin could be removed. The cost-benefit analysis showed these processes only increased 0.03 to 0.14 yuan RMB cost per cubic meter of water, for example, by using ozone pretreatment and oxidation plus adsorption processes. Conclusion On the basis of general water treatment, ozone(O3), potassium permanganate(KMnO4), chlorine, dioxide(ClO2)and powdered activated carbon(PAC) are effective for removing microcystin in pretreatment processes and the processes are cheaper and practical.

Objective To investigate the characteristics of nerve injury and incidence of carpal tunnel syndrome(CTS)indiabeticpatientsbymeasuringthenerveconductionvelocity(NCV). Methods Atotalof387 inpatients with type 2 diabetes were selected in Kaifeng Central Hospital from July 1, 2011 to October 1, 2014. The abnormal rates of NCV between left and right or male and female for the same name nerve were compared. The examinations to median nerves were paid particular attention and the segmental test was performed. Results Among 387 patients, 333 cases showed abnormal NCV, and 162 patients (41. 9%) presented with CTS. The incidence of sensory nerve injury was higher than that of motor nerve injury. The nerve injury often occurred in the dominant hand, but the injury of bilateral hand were also found in some patients. In 162 patients with CTS, 91 patients presented with clinical manifestations and signs, and the rest were without discomfort in their hands. The percentages of SCV(34. 1%vs 25. 6%, P=0. 012) and MCV (40. 3% vs 29. 5%, P=0. 020) abnormality in the right median nerve were higher than those in the left side. No significant difference of the other nerves was found between left and right. Significant differences in the percentages of abnormality in SCV of the left median nerve (21. 4%vs 30. 5%, P=0. 047) and the right median nerve (28. 6%vs 40. 1%, P=0. 013) between man and woman were found. The abnormal rates of other nerves were without statistically significant between man and women. Conclusions The incidence of CTS is high in diabetic patients. Usually, it firstly occurs in sensory nerves, followed by motor nerves, especially in the dominant hand.

With the process of internalization of traditional Chinese medicine(TCM) accelerating increasely, intensive study on international educational reform of TCM is significant. This article elaborates importance of international educational reform of TCM from development situation of Tianjin University of Traditional Chinese Medicine, combined with regional characteristics, find that intensifying the reform and expanding the opening up of international education of TCM is an Important Channel of international development of Tianjin, a reflection of national willpower, a corollary of adapting to the development trend of the economic globalization and an inevitable requirement and powerful guarantee of internalization of TCM. Therefore, we hold that international educational reform of is imperative to achieve the internalization of TCM.

Objective:To evaluate the efficiency of using artificial intelligence reading label system in diabetic retinopathy (DR) grading training among junior ophthalmologists and medical students.Methods:520 diabetic fundus images were randomly divided into 8 groups with 65 images in each group. 13 junior ophthalmologists and medical students were selected as the research objects. Each of them read 8 groups of pictures and evaluated the DR grading of each fundus image. The sensitivity, specificity and diagnostic test consistency (Q-kappa value) of grading results were analyzed with the DR grading given by 3 senior ophthalmologists as the gold standard. The average Q-kappa values of 13 subjects were compared between the first four times and the last four times.Results:Through 8 round reading, the average Q-kappa was elevated from 0.67 to 0.81. Average Q-kappa of round 1 to 4 was 0.77, and average Q-kappa of round 5 to 8 was 0.81. The participants were divided into two groups. Participants in group 1 were junior ophthalmologists and participants in group 2 were medical students. Average Q-kappa of group 1 was elevated from 0.71 to 0.76. Average Q-kappa of group 2 was elevated from 0.63 to 0.84.Conclusions:The artificial intelligence reading label system was a useful tool in training junior ophthalmologists and medical students in doing diabetic retinopathy grading.

OBJECTIVE: To explore the application of double pedicle blood supply pectoralis major myocutaneous flap in reconstruction of laryngeal and hypo pharyngeal defect after carcinoma resection. METHOD: All the patients received initial treatment. Pectoralis major myocutaneous flap was Applied in one-stage reconstruction in 22 cases of laryngocarcinoma and hypopharyngeal carcinoma with post-operation defect. During operation, pectoral branches of thoracoacromial vessels and branch of lateral thoracic vessels were reserved and prepared to be double pedicle vessel fascia bundle without muscle at the beginning part, rearched to defect area through subclavian tunnel. After operation, it is necessary to closely observe the subcutaneous swelling, quantity and color of the drain and others of neck surgery area to exclude the occurrence of surgical hematoma. When there is suspicion, do timely exploration. RESULT: Pectoralis major myocutaneous flaps of 22 patients were all survived. Pharyngeal fistula occurred in 2 cases and was cured by change of dressing. Twenty-one cases received radiotherapy after operation without secondary flap necrosis. After follow-up of 6 months to 24 months, one case of roll repairment of circumferential defect in cervical esophagus,found to have anastomotic stenosis 8 months after radiotherapy and then underwent gastrostomy treatment,the other 21 cases showed good recovery of swallowing function. Among 13 cases with laryngeal function reserved, only 1 case wearing tube and the extubation rate was 92.3% without communication barriers, no patient died in the short follow-up period. CONCLUSION For double pedicle blood supply pectoralis major nyocutaneous flap, blood supply are fully guaranteed and does not require complicated equipment to observe and monitor the flap blood supply after operation, it is important to exclude factors that may lead to muscular flap necrosis to ensure the survival of pectoralis major myocutaneous flap.
Esophagus ; surgery ; Fistula ; pathology ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Laryngeal Neoplasms ; surgery ; Larynx ; surgery ; Myocutaneous Flap ; Pharynx ; pathology ; surgery ; Reconstructive Surgical Procedures

Pulse-taking, as one of the four diagnostic methods of inspection, auscultation and olfaction, inquiry and pulse-taking, can fully embodies the characteristics of traditional Chinese medicine. Pulse-taking is the teaching key point for the international students. However, because the pulsetheory and literature is quite profound and abstract and there is a long distance between the class teaching and clinical practice, the teaching of pulse-taking is also the difficult point for the international students. Therefore, the pulse-taking teaching should focus on the interesting teaching, the culture of traditional Chinese medicine of pulse, image teaching and practice training.

Objective To investigate the effects of pemphigus vulgaris (PV) on pregnancy,childbirth and neonates.Methods Clinical data were collected from 8 pregnant patients with PV who visited the Peking University First Hospital and received follow up.Results Of these patients one developed PV in the third trimester of pregnancy,and the other 7 received treatment for PV and achieved complete subsidence of mucocutaneous lesions before pregnancy.Among the 7 cases,6 were treated with prednisone ＜ 10 mg/d,and 1 was treated with prednisone 22.5 mg/d.Finally,1 patient was lost to follow-up,1 patient underwent artificial abortion on about day 40 of pregnancy with no fluctuation in disease activity.Six patients delivered a normal birth weight baby at term,of whom,1 experienced fluctuation in disease activity in mid-pregnancy,1 suffered from recurrence of PV as a result of drug withdrawal at 2 months after delivery,and the other 4 showed no changes in disease activity.Four out of six neonates were healthy,while two were born with neonatal PV and healed after topical treatment.Conclusions Safe pregnancy and delivery can be achieved in patients with PV whose condition is completely under control with lowdose glucocorticoids after withdrawal of immunosuppressive agents.Although there is a risk of PV in neonates,the prognosis is optimistic.

A three-dimensional (3D) transrectal ultrasound (TRUS) imaging system is presented in this paper. The 3D imaging system is used for diagnosing diseases of prostate. The 3D image is reconstructed by a series of two-dimensional image data which is obtained through rectum. It can be a guide to prostate needle biopsies. The system is built by two parts: hardware and software. In the hardware, the mechanical device, stepper motor, control circuit, B Mode TRUS and personal computer (PC) workshop are presented. The software includes the firmware of micro control unit and software of the PC workshop. In order to evaluate the performance of the 3D imaging system, we did experiments with water and agar phantoms, and the results demonstrated the system's ability of 3D imaging with high-precision.
Biopsy, Needle ; Humans ; Imaging, Three-Dimensional ; instrumentation ; Male ; Phantoms, Imaging ; Prostate ; diagnostic imaging ; Rectum ; Software ; Ultrasonography