Background Cataract is the main cause of global blindness,and surgery is the main method for the treatment of cataract,so precise preoperative parameters have an important significance for improving postoperative visual quality.Objective This study was to analyze the difference of lens thickness (LT) measured by immersion A-scan ultrasound versus optical biometry and consistency of these two methods in measuring the LT for different types of cataract eyes,and to investigate whether A-scan ultrasound for the LT measurement needs to correct the ultrasound speed parameter.Methods A reliability evaluation of diagnosis test was designed.The LT was measured on 143 cataract eyes using immersion A-scan ultrasound and Lenstar optical biometry in Tianjin Eye Hospital from September 2013 to May 2014.The eyes were assigned to nuclear cataract group (60 eyes of 50 patients),posterior subcapsular cataract group (40 eyes of 40 patients) and cortical cataract group (43 eyes of 43 patients) based on the types of cataract,and the hardness of nucleus was grade II in 20 eyes of 14 patients,grade Ⅲ in 20 eyes of 17 patients and grade Ⅳ in 20 eyes of 19 patients.The outcomes measured by immersion A-scan ultrasound versus Lenstar optical biometry were compared with paired t test,and the consistency between the two devices was analyzed by Bland-Altman agreement plot.This study complied with Helsinki declaration,and written informed consent was obtained from each patient prior to any examination.Results The mean LT value was (4.85± 0.39) mm from the immersion A-scan ultrasound and (4.74 ±0.37)mm from the Lenstar optical biometry,with a significant difference between the two devices (t =3.020,P =0.004).No significant differences were found in the LT values of the posterior subcapsular cataractous eyes and cortical cataractous eyes between the two devices (t=1.015,P =0.316;t =1.275,P =0.209).The LT values by immersion A-scan ultrasound were significantly higher in grade Ⅱ,Ⅲ and Ⅳ nuclear cataractous eyes than those by Lenstar optical biometry (t=2.175,2.378,2.383,all at P＜0.05).The outcome showed a good consistency in the posterior subcapsular cataractous eyes between the two measuring methods,with the 95％ limitation of agreement (LoA) from-0.21 to 0.18 mm.However,there were poor consistencies between the two measuring methods in the nuclear and cortical cataractous eyes,with the 95％ LoA from-0.64 to 0.43 mm and from-0.50 to 0.41 mm,respectively.Poor consistencies also were seen in grade Ⅱ,Ⅲ,Ⅳ nuclear cataractous eyes between the two measuring methods,and the 95％ LoA were-0.31 to 0.22 mm,-0.32 to 0.24mm and-1.09 to 0.62 mm,respectively.Conclusions There are differences in measuring LT of different types of cataractous eyes between immersion A-scan ultrasound and Lenstar optical biometry.The measuring values are higher by immersion A-scan ultrasound than those by Lenstar optical biometry,suggesting that the measurement of immersion A-scan ultrasound for LT of different types and nuclear hardness of cataractous eyes should correct the ultrasound speed parameters.

Objective:To screen and analyze the prognostic protein biomarkers of DLBCL, and to explore their value in the prognostic evaluation.Methods:163 cases of confirmed DLBCLs from January 2011 to December 2016 were collected with their clinical, pathological and follow-up data, which were all from our hospital. The expression of protein markers were tested using immunohistochemical staining (IHC) . The immune phenotypes independent of the International Prognostic Index (IPI) that affect overall survival (OS) and progression-free survival (PFS) of DLBCL were explored by COX regression model, and the effect of their co-expression on the prognosis were also analyzed.Result:BCL6 negative (PFS: HR=1.652, 95% CI 1.030-2.649, P=0.037) , P53 positive (OS: HR=1.842, 95% CI 1.008-3.367, P=0.047) , and BCL2 strong positive expressions (S+) (OS: HR=2.102, 95% CI 1.249-3.537, P=0.005; PFS: HR=2.126, 95% CI 1.312-3.443, P=0.002) are adverse prognostic factors of DLBCL that are independent of IPI. BCL6 - (PFS: HR=2.042, 95% CI 1.021-4.081, P=0.043) , P53 + (OS: HR=3.069, 95% CI 1.244-7.569, P=0.015) and BCL2 S+ (OS: HR=2.433, 95% CI 1.165-5.082, P=0.018; PFS: HR=3.209, 95% CI 1.606-6.410, P=0.001) are adverse prognostic factors in the group of age≤60-year-old; in the group of IPI score 0-2, cases with BCL6 - (OS: HR=2.467, 95% CI 1.322-4.604, P=0.005; PFS: HR=2.248, 95% CI 1.275-3.965, P=0.005) and BCL2 S+ (PFS: HR=2.045, 95% CI 1.119-3.735, P=0.020) have worse prognosis. The co-expression of BCL6 - and BCL2 S+ has significant influence on prognosis of DLBCL ( P=0.005 and P<0.001) , in which BCL6 +/non-BCL2 S+ ( n=86) has the best prognosis[3-year-OS (71.6±4.9) %, 3-year-PFS (67.0±5.1) %], and BCL6 -/BCL2 S+ ( n=10) has the worst prognosis[3-year-OS (20.0±12.6) %, 3-year-PFS (10.0±9.5) %]; the co-expression of BCL6 - and P53 + has no significant influence on prognosis ( P=0.061 and P=0.089) , however, those cases with BCL6 +/P53 - ( n=98) often get better prognosis[3-year-OS (70.6±4.7) %, 3-year-PFS (64.6±4.9) %] than others; the co-expression of P53 + and BCL2 S+ has significant influence on prognosis of DLBCL ( P<0.001 and P<0.001) , and P53 +/BCL2 S+ ( n=5) has the worst prognosis (3-year-OS and 3-year-PFS are both 0) ; BCL2 S+ cases get shorter OS and PFS, regardless of the expression of BCL6 and P53. Conclusion:The expression and co-expression of BCL6 negative, P53 positive and BCL2 S+ have certain value in the prognostic evaluation of DLBCL, especially in the group of age≤60-year-old and IPI score 0-2.

Objective:To summarize the clinical and pathological features of intravascular NK and T cell lymphoma for better understanding of such disease to reduce misdiagnosis and miss-diagnosis.Methods:Clinical and pathological features were analyzed retrospectively in one case of intravascular peripheral T-cell lymphoma, not otherwise specified (IVPTCL, NOS) , with literatures review.Results:The case presented in this study was a 66-year-old man. PET/CT scan showed multiple lymph nodes enlargement throughout the body. Normal lymph node structure could not be observed by tissue biopsy, while lymph follicles were partially disrupted. High-power light microscope revealed a large number of blood vessels with diffuse proliferation and dilation, where atypical lymphoid cell mass was restricted in the lumen and partially infiltrated the large blood vessel wall. These tumor cells were medium to large with moderate cytoplasm. The nucleus was irregular, single or multiple nucleoli could be seen, chromatin was condensed, some were empty and bright, and mitotic figures could be seen. Immunohistochemical staining showed that the neoplastic cells were positive for expression of CD3, CD43, CD8, GrB, TIA-1 and perforin. EBER in situ hybridization result was negative. Polymerase chain reaction test identified a clonal gene rearrangement of T-cell receptor γ. The patient was treated with CHOP in combination with chidamide, but died of infection and cardiopulmonary failure within 2 months. 56 cases of intravascular NK/T cell lymphoma with definite classification were collected from relevant literatures, including 47 cases with nasal type of extranodal NK/T cell lymphoma (27 were male and 20 were female) , 8 cases with anaplastic large cell lymphoma (3 males and 5 females) , and only one case with de nova IVPTCL, NOS in brain. We report the second case of IVPTCL,NOS, and notably originated from lymph node for the first time.Conclusions:Intravascular NK/T cell lymphoma is a highly aggressive disease with no effective treatment at present. Involvement of Lymph node has rarely been reported, and further studies on more cases are necessary.