Objective:To survey the expression of MMP-1,MMP-2 of human periodontal ligament cells(HPDLCs)treated by tea polyphenols(TP)and lipopolysaccharide(LPS).Methods:HPDLCs were in vitro cultured in vitro and treated by TP(200 μg/ml) and /or LPS(100 μg/ml)for 24,48 and 72 h respectively,the secretion of MMP-1 and MMP-2 were examined by ELISA,MMP-1 and MMP-2 mRNA expression was examined by real-time PCR.Results:The secression and mRNA expression of MMP-1 and MMP-2 of HPDLCs increased by LPS treatment and significantly inhibited by TP at the different times.Conclusion:TP can inhibit the col-lagen degradation of HPDLCs mediated by LPS.

Objective:To study the clinical features, therapeutic effects, survival time, and prognosis of patents with mantle cell lymphoma (MCL). Methods:Clinical data of 98 MCL patients admitted from January 2005 to December 2013 were retrospectively an-alyzed. Results:The median age was 61 years old, and the male-to-female ratio was 2.9∶1. Among these cases, 85 (86.8%) were in Ann Arbor stageⅢ-Ⅳ, 46 (46.9%) had bone marrow involvement, 25 (25.5%) had digestive tract involvement, and 53 chose R-CHOP as first-line treatment. The expected 3-year overall survival (OS) of these patients was only 61.4%. A total of 14 cases were treated with R-CHOP followed by ASCT. The expected 5-year OS was 92.3%, and the OS of the ASCT group was significantly higher than that of the R-CHOP group (75.5 months vs. 43.6 months, P=0.039). Elevated ESR,>60 years old, increased LDH level, B symptoms, and Ki-67≥25% were poor prognostic factors. Conclusion: Most patients with MCL were elder adults with bone marrow involvement. R-CHOP followed by ASCT had better clinical efficacy than conventional chemotherapy in the treatment of MCL.

Objective: To evaluate the value of Prostate Imaging Reporting and Data System Version 2 (PI-RADS ) based biparametric magnetic resonance imaging (bpMRI) for predicting prostate biopsy results in patients with elevated prostate specific antigen (PSA). Methods: The bpMRI from 539 patients who took transperineal template saturate biopsy from January 2015 to October 2017 were assessed retrospectively. The average age was 69.5 years old (44-88 years), with tPSA level of 7.23 ng/ml (4-10 ng/ml), f/t PSA of 0.183( 0.016-0.504), PSAD of 0.126 ng/ml² ( 0.025-0.534 ng/ml²) , PV of 72.42 ml ( 18.71-199.51 ml). The age, PSA level, free/total PSA ratio, PSA density, prostate volume, and PI-RADS score of enrolled patients were analyzed for univariate analysis and their difference was compared by chi-square test, t-test. The multivariate logistic regression analysis was also performed through SPSS to select the independent risk factors for prostate cancer (PCa) and clinically significant cancer (csPCa). The receiver operating characteristic curves were also constructed to analyze the sensitivity and specificity of PI-RADS in PCa to explore the best cut-off value for the diagnosis of PCa and csPCa. Results: A total of 539 patients were included in our study with 244 cases being positive and 295 cases being negative. In patients with positive results, 59 patients were diagnosed csPCa. According to univariate analysis results, the age(P<0.001) and PI-RADS score (P<0.001) of the positive patients were higher than the negative patients, and the difference was statistically significant. The age of the csPCa patients (P=0.023), PSAD (P=0.048) and PI-RADS scores (P<0.001) were higher than those of InsPCa patients, and f/t PSA (P=0.027) was lower than that of InsPCa patients with statistically significance. Multivariate logistic regression analysis demonstrated that f /t PSA (OR=2.283, P=0.049) and PI-RADS score (OR=9.046, P<0.001) were independent risk factors for positive biopsy results, while PSAD (OR=4.54, P=0.038) and PI-RADS score (OR=8.254, P<0.001) were independent risk factor for csPCa. The Yoden index analysis of different thresholds for prostate cancer detection indicated that PI-RADS 3 was the optimal threshold for the diagnosis of PCa, and PI-RADS 4 was the optimal threshold for the diagnosis of csPCa. Based on the combination of the above factors, the positive rate of prostate cancer was relatively high in patients with PI-RADS score ≥3 and f/t PSA<0.2 , which accounted for 86.6%(181/209). In contrast, the positive rate in patients with a PI-RADS score of ≤2 and f/t PSA≥0.2 was low, which accounted for 10.7%(6/56). The positive rate of csPCa was relatively high in patients with PI-RADS score≥4 and PSAD≥0.15 ng/ml^2, which accounted for 76.0%(38/50). The positive rate of csPCa detected in patients with ≤3 and PSAD<0.15 ng/ml² was low, which accounted for 0(0/359). Conclusions PI-RADS score could be used to reduce the unnecessary prostate biopsies in patients with elevated PSA when combined with other PSA related markers. Patients with a PI-RADS score of ≤3 and a PSAD ratio <0.15 ng/ml² could avoid unnecessary biopsies.

Objective:To evaluate the epidemiology of bacterial bloodstream infections in patients submitted to hematologic wards in southern China.Methods:A total of 50 teaching hospitals were involved based on the China Antimicrobial Resistance Surveillance System. The data of clinical isolates from blood samples were collected from January 1, 2019, to December 31, 2019. Antimicrobial susceptibility testing was conducted by the Kirby-Bauer automated systems, and the results were interpreted using the CLSI criteria.Results:The data of 1,618 strains isolated from hematologic wards in 2019 were analyzed, of which gram-negative bacilli and gram-positive cocci accounted for 71.8% and 28.2%, respectively. Of those, the five major species were most often isolated, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, coagulase-negative staphylococcus, and Streptococcus viridans. The prevalence rates of methicillin-resistant strains in Staphylococcus aureus and coagulase-negative staphylococcus were 19.7% and 80.6%, respectively. No gram-positive cocci were resistant to vancomycin, linezolid, and teicoplanin, and none of the enterococci were resistant to linezolid. The resistance rate of S. viridans to penicillin G was 6.9%, and those to ceftriaxone and cefotaxime were more than 25%. The resistance rate of E. coli and K. pneumoniae in Enterobacteriaceae was higher in children than that in adults. The resistance rate of K. pneumoniae to meropenem was 14.1%. The resistant rate of Enterobacter cloacae to carbapenem was more than 25%. P. aeruginosa was more sensitive to more antibiotics than 80%, but the resistance rate to meropenem in children was higher than that in adults (11.8% vs. 6.5%). The proportion of gram-positive cocci in the ICU and respiratory departments was higher than that in the hematology department. The detection rates of carbapenem-resistant E. coli and K. pneumoniae in the respiratory department were the lowest with 0.3% and 3.7%, respectively, while those of CRPA and CRAB in the hematology department were the lowest with 8.3% and 25.8%, respectively. The detection rate of all carbapenem-resistant organisms in the ICU was the highest among the three departments.Conclusion:The etiology and drug resistance of bacteria from blood samples in the hematology department are different from those in the ICU and respiratory departments. The proportions of K. pneumoniae, P. aeruginosa, E. cloacae, and S. viridans dominating in the department of Hematology were significantly higher than those in the ICU and respiratory departments in Guangdong region.

OBJECTIVETo compare the prognostic value of different models in patients with early-stage diffuse large B-cell lymphoma (DLBCL).

METHODSEarly-stage DLBCL patients diagnosed from January 2000 to December 2012 were analyzed retrospectively. All patients received with at least 2 cycles of immunochemotherapy R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) with or without radiotherapy. The prognostic value of international prognostic index (IPI) , revised IPI (R-IPI) and enhanced IPI (NCCN-IPI) was compared.

RESULTSNinety-seven cases of early-stage DLBCL were included in the study. The median age was 58 years (15-88 years) with a median follow-up of 34.7 months (range 7.3-77.4 months). The expected 5-year overall survival (OS) for entire group was 82%. There was no patient in the high risk group according to IPI or NCCN-IPI. According to IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 95%, 38% and 60%, respectively. According to R-IPI, the 5-year OS in the very good, good, and poor risk groups were 93%, 75% and 60%, respectively. According to NCCN-IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 92%, 85% and 29%, respectively.

CONCLUSIONNCCN-IPI would be of an ideal prognostic model for early-stage DLBCL patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Murine-Derived ; Antineoplastic Combined Chemotherapy Protocols ; Cyclophosphamide ; Doxorubicin ; Humans ; Immunotherapy ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; Middle Aged ; Prednisone ; Prognosis ; Retrospective Studies ; Rituximab ; Vincristine ; Young Adult

Objective: To investigate the clinical features, diagnosis, treatment and prognosis of primary intestinal lymphoma (PIL) . Methods: The characteristics, diagnosis, treatment methods, and follow-up outcomes of 99 PIL patients, diagnosed in Peking university cancer hospital between Nov.1,1995 and Nov. 30, 2013. Results: There were 65 males and 34 females with a median age of 50 years. The majority of clinical manifestation were non-specific gastrointestinal symptoms, 67.68% of cases presented abdominal pain, 26.26% with acute abdomen. The most common primary sites of ileum and ileocecus were identified in 21 cases, respectively. The positive rate of endoscopic was only 24.24%, and 69 cases were diagnosed by operation. 71 patients (71.72%) were stageⅠ-Ⅱand 28 patients (28.28%) were stage Ⅳ. Hodgkin’s lymphoma was not found in all patients. Of the 99 cases, 77 were B-cell origin (77.78%) and 22 were T-cell origin. 55 cases (55.56%) were diagnosed with diffuse large B cell lymphoma (DLBCL) . 60 cases presented IPI score 0-1 point. The median overall survival (OS) was 100.0 months, and 5 year overall survival (5y-OS) was 53.5%. By multiple-factors analysis, T-cell origin lymphoma was significantly correlated with poor prognosis (P<0.05) . There was no difference of the median OS between the patients with operation and chemotherapy alone (79.0 vs 123.0 months, P=0.616) . Conclusion PIL is commonly seen in males. Abdominal pain is the most common clinical manifestations and the most primary sites are ileum and ileocecus. The diagnosis value of the endoscopic is limited. DLBCL is the most common pathologic type of PIL. T-cell origin lymphoma is an independent prognostic factor for PIL. Surgery is still commonly used in the diagnosis and treatment of PIL, and the operation do not increase the risk of death of patients with PIL.

Objective: To evaluate the prognostic value of ¹⁸F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B cell lymphoma (DLBCL) undergoing autologous hematopoietic stem cell transplantation (auto-HSCT). Methods: Forty-eight patients with DLBCL treated at Peking University Cancer Hospital between November 2010 and December 2014 were assessed. All patients underwent PET/CT scanning prior to or after auto-HSCT. Correlation analysis was done based upon patients characteristics, PET/CT scan results and survival. Results: ①Among 48 patients, 27 was male, 21 female, median age was 43 (17-59) years old. ② Patients with negative pre-auto-HSCT PET/CT assessment demonstrated significantly better 3-year progression free survival (PFS) (87.1% vs 53.3%, χ²=7.02, P=0.019) and overall survival (OS) (90.3% vs 60.0%, χ²=6.51,P=0.022) than patients with positive pre-auto-HSCT PET/CT assessment. Three-year PFS (94.1% vs 30.0%, χ²=22.75, P=0.001) and OS (97.1% vs 40.0%, χ²=21.09, P=0.002) were also significantly different between patients with negative and positive post-auto-HSCT PET/CT assessment. ③ Multivariate analysis indicated a significant association of PFS (HR=13.176, P=0.005) and OS (HR=20.221, P=0.007) with post-auto-HSCT PET/CT assessment. Number of prior treatment regimens was associated with PFS (HR=10.039, P=0.040). ④ Harrell’s C index revealed that the value of combined use of number of prior treatment regimens and post-auto-HSCT PET/CT assessment was superior to either one used alone in PFS (Harrell’s C values were 0.976, 0.869 and 0.927 in combined use, number of prior treatment regimens and post-auto-HSCT PET/CT assessment, respectively), and the combined use of ECOG performance status and post-auto-HSCT PET/CT assessment significantly increased the Harrell’s C index in OS (Harrell’s C values were 0.973, 0.711 and 0.919 in combined use, ECOG performance status and post-auto-HSCT PET/CT assessment, respectively). Conclusions Post-auto-HSCT PET/CT assessment is the main predictor of outcomes in DLBCL patients receiving auto-HSCT. Combined use of post-auto-HSCT PET/CT assessment and number of prior treatment regimens and ECOG performance status is a better prognostic tool in patients with DLBCL undergoing transplantation.

Objective: To evaluate the clinical characteristics and survival outcomes of patients with de novo grade 3 or transformed follicular lymphoma (FL). Methods: Fifty-two patients treated at Peking University Cancer Hospital between January 2009 and September 2017 were assessed, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. Baseline characteristics, survival and prognostic factors were analyzed. Results: ① Twenty-six male and 26 female patients were enrolled, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. ②The 3-year progression-free survival (PFS) and overall survival (OS) for the entire cohort were 56.0% and 80.6%, respectively. Patients with international prognostic index (IPI) score 0-1 demonstrated significantly better 3-year PFS (80.3% vs 20.1%; t=18.902, P<0.001) and OS (95.7% vs 57.0%; t=10.406, P<0.001) than patients with IPI score 2-3. Three-year PFS (94.1% vs 37.2% vs 25.2%; P=0.002) and OS (100.0% vs 76.0% vs 59.8%; P=0.020) were also significantly different among patients with FLIPI 1 score 0-1, 2, ≥3. FLIPI 2 score was also identified as a prognostic factor for 3-year PFS (68.4%, 0, 0; P=0.001) and OS(87.5%, 76.2%, 0; P=0.003). ③Multivariate analysis indicated a significant association of PFS (HR=3.536, P=0.015) and OS (HR=15.713, P=0.015) with IPI. FLIPI 2 was associated with OS (score 0-1, HR=0.078, P=0.007; score 2, HR=0.080, P=0.022). Conclusion De novo grade 3 or transformed FL might be a group of curable disease with current treatment strategies. IPI is still a prognostic tool in this scenario.

Chimeric antigen receptor T (CAR-T) cell has achieved excellent efficacy in hematological tumors, especially for lymphoma. Many products have been approved to market all over the world, and 2 products targeting CD19 have been approved to treat relapsed and refractory large B-cell lymphoma in China. The current experiences of using CAR-T cells come from previous clinical studies. How to use CAR-T cells in a standardized and rationalized way is still a challenge faced by our clinicians. Based on the CAR-T cell treatment experiences from Peking University Cancer Hospital and the latest research progresses in CAR-T in China and abroad, this article will elaborate on patient screening, peripheral blood mononuclear cell collection, bridging treatment, lymphocyte depletion chemotherapy, CAR-T cell infusion, the monitoring and treatment of adverse events after infusion, and long-term follow-up after infusion, in order to guide clinicians to better use CAR-T cell and to bring maximum benefits to patients.

Objective:To assess the efficacy and toxicity of chemoradiotherapy in the treatment of early stage extranodal nasal-type NK/T-cell lymphoma (ENKTCL).Methods:Retrospective review was conducted for 174 patients with pathological proved early stage ENKTCL who were treated in the Department of Radiation Oncology, Peking University Cancer Hospital & Institute. The Kaplan-Meier survival analysis was adopted to calculate the local-regional control (LRC), overall survival (OS), and progression free survival (PFS), and the Log-rank test COX regression model were applied to univariate and multivariate analyses.Results:The patients in this study included 102 and 72 patients diagnosed with Ann Arbor stage-Ⅰ and stage-Ⅱ, respectively. Among them, two patients received radiotherapy alone and 172 patients were treated with combined chemoradiotherapy. The overall response rate of all the patients was 94.2%, with a complete response (CR) rate of 87.9% (153). Furthermore, the rates of 5-year OS, PFS, and LRC were 87.3%, 83.1%, and 91.9%, respectively. The most common toxicities during the chemotherapy and radiotherapy included myelosuppression and oral mucositis, with grade ≥ 3 myelosuppression and grade ≥ 3 oral mucositis accounting for 62.1% and 10.9% of all patients, respectively. As shown by multivariate analysis, the adverse prognostic factors for OS included age > 60, B symptoms, and stage Ⅱ, while the adverse prognostic factors for PFS included age > 60 and stage Ⅱ. Meanwhile, the PFS rate was significantly improved by increasing the radiation dose (≥ 50 Gy vs.<50 Gy), and the 5-year PFS rates of the two groups were 83.5% and 76.5%, respectively [hazard ratio ( HR) 0.374; 95% CI, 0.169-0.826; P=0.015]. Conclusions:A good therapeutic effect can be achieved for early stage NK/T-cell lymphoma and the toxicities after combined chemoradiotherapy can be tolerated.