Purpose　To investigate the clinicopathological and immunohistochemical features of Epstein-Barr virus-associated and Epstein-Barr virus not-associated primary intestinal T-cell lymphomas(ITCL) and to study their cell origins. Methods　In situ hybridization for EBER1/2 and immunohistochemical staining for immunophenotypes, LMP-1,TIA-1,bcl-2 and CD21 were performed in 32 cases. The clinical data were analyzed and all patients were followed-up. Results　(1) In 27 of the 32 cases, EBER1/2 were detected in the tumor cells, in which 11 presented LMP-1 positive reactions. (2) All 32 cases of ITCL revealed CD45RO positivity，in which 4（12.5%） expressed CD8，8（25.0%）expressed CD4, 9（28.1%）expressed CD56,and 31（96.9%）expressed TIA-1. There were 17（53.7%）cases with CD4-，CD8-，CD56- immunophenotype. None expressed bcl-2 and CD21. 32 ITCL were classified into pleomorphic medium and large cell(n=28), monomorphic medium-sized(n=2), pleomorphic small cell(n=2). Clinically, most patients with ITCL were young males with abdominal pain, hematochezia, fever and weight loss. The prognosis of patients with ITCL showed poor (survival median was 1.7 month). (3) The differences between EBV-associated and EBV not-associated ITCL lay in hematochezia, fever and the expression of CD3, CD8 and CD56. Conclusion　Most of Chinese ITCL are EBV-associated ones with unusual clinicopathological and immunohistochemical features，which are of different lineages of T-cell subtypes, including cytotoxic T-cell or NK cell.

OBJECTIVETo investigate the roles of different clinicopathological features and expression of EBV genome in prognosis of intestinal T-cell lymphoma (ITCL).

METHODSPolymerase chain reaction for TCR-gamma gene rearrangement, in situ hybridization for EBER1/2 and immunohistochemical staining for CD4, CD8, CD45RO, CD56, TIA-1 were investigated and all patients followed-up. The LMP-1 expression was determined in forty-two ITCLs cases. The relationship between clinical data, different clinicopathological features, expression of EBV genome and prognosis were analyzed by SPSS10.0 program.

RESULTS(1) All 42 cases of ITCL had an extremely poor prognosis with a median survival of 3.0 months, of which the one year survival rate and two year survival rate being 30% and 22% respectively. (2) The patients without TCR-gamma gene rearrangements showed poorer prognosis than those with TCR-gamma gene rearrangements, and the patients who received operation and chemotherapy showed better prognosis than those who only received operation (P < 0.05). (3) No significant prognostic factor for ITCLs was determined.

CONCLUSIONThe special clinicopathological features of ITCL could be due to the cytotoxic function and the role of EBV infection in the pathogenesis of ITCL.

Adolescent ; Adult ; Child ; Female ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Humans ; Intestinal Neoplasms ; mortality ; pathology ; therapy ; Lymphoma, T-Cell ; mortality ; pathology ; therapy ; Male ; Middle Aged ; Prognosis ; Survival Rate

In order to provide inspirations and suggestions for the development of medical examination methods in the future, this essay applies SWOT analysis to probe into the strengths (S), weaknesses (W), opportunities (O) and threats (T) of current online assessment method, matches any two of them for analysis, and therefore puts forward four strategies accordingly from the perspective of SO, WO, ST and WT.

Objective:To explore the efficacy and compliance of e-aid cognitive behavioral therapy (eCBTI) in patients with situational insomnia among different age groups.Methods:A total of 194 patients with situational insomnia were recruited via a campaign of the " Prevention and Protection Handbook Against Epidemic" from March to April 2020 in Guangzhou, China.Participants were divided into two groups according to age: under 35 years old ( n=87) and 35 years old and above ( n=107). They all received one-week eCBTI intervention.Insomnia severity index (ISI), Pre-sleep arousal scale (PSAS) and Hospital anxiety and depression scale (HADS) were used to evaluate the severity of insomnia for all participants pre- and post-intervention.The change of each scale within the group and the reduction rate of each scale between groups were compared using t test and one-way ANOVA. Results:(1) Intervention efficacy: in the <35-year-old group, compared with baseline, the scores of ISI scale ((9.2±4.1), (14.8±5.1)), PSAS cognitive arousal subscale ((18.5±8.4), (23.5±6.6)), PSAS((34.3±15.8), (40.3±10.7)), HADS depression subscale ((5.8±3.6), (8.5±4.6)) and HADS anxiety subscale((7.1±3.9), (9.5±4.5) )were statistically significant after eCBTI intervention ( t= 2.88-8.80, all P<0.01), but there was no significant difference in score of PSAS body subscale ((15.8±7.8), (16.8±5.7)). In ≥35-year-old group, compared with baseline, the scores of ISI scale ((9.7±4.2), (14.4±4.3)), HADS depression subscale ((4.6±2.2), (6.6±3.5))and PSAS cognitive arousal subscale ((16.9 ±8.5), (20.0±5.8))were significantly different after intervention ( t= 2.90-6.86, all P<0.01), meanwhile the scores of PSAS body subscale ((14.3±8.0), (13.9±5.2)), PSAS((32.2±16.5), (33.9±9.2)), HADS anxiety subscale((6.1±3.2), (7.0±3.5)) were not statistically significant (all P>0.05). There was no significant difference in the score reduction rate between the two groups before and after intervention (all P>0.05). (2) Compliance: 86 cases dropped out, and the dropout rate was 61.3%.Totally 75 cases (38.7%) completed the 7-day treatment, and 119 cases (61.3%) completed the treatment within 1-6 days.Further study found that there was statistically significant difference in the reduction rate of ISI total score among the three groups with excellent, good and poor compliance ( F=5.655, P=0.004). Conclusion:eCBTI has a good effect on situational insomnia in different age groups, and there is no difference in treatment compliance.