The over-activation of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mechanistic target of rapamcyin (mTOR) pathway is closely related to the occurrence, development and clinical prognosis of malignant tumors. Taking this signal pathway as a target can effectively inhibit tumor progression. At present, the Food and Drug Administration of the United States has approved three drugs (CAL-101, BAY80-6946, IPI-145) for the treatment of recurrent and refractory indolent non-Hodgkin lymphoma, which demonstrates significant efficacy and a manageable safety profile.

Objective:To investigate the prognostic significance of D-dimer level in patients with diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 70 newly diagnosed DLBCL patients who were admitted to Tianjin People's Hospital from January 2015 to June 2019 were retrospectively analyzed. The optimal cut-off value of D-dimer for survival was determined according to the receiver operating characteristic (ROC) curve, and the patients were grouped. The differences of coagulation related indexes and clinicopathological features between patients with different D-dimer levels were compared. Kaplan-Meier method was used for univariate analysis of overall survival (OS), and Cox regression model was used for multivariate analysis of OS.Results:According to ROC curve, the best cut-off value of D-dimer for survival was 0.75 mg/L. The proportion of patients with different clinical staging, international prognostic index score, lactate dehydrogenase level had statistically significant differences between the D-dimer ≥0.75 mg/L group (36 cases) and <0.75 mg/L group (34 cases) (all P < 0.05). The prothrombin time of D-dimer ≥ 0.75 mg/L group and < 0.75 mg/L group were (13.5±0.9) s and (13.0±0.8) s, respectively, and the activated partial thromboplastin time were (37±5) s and (34±6) s, respectively,and the differences were statistically significant (all P < 0.05). Univariate analysis showed that the 5-year OS rates of DLBCL patients with Ann Arbor stage Ⅲ-Ⅳ, international prognostic index score > 2, lactate dehydrogenase level > 240 U/L, B symptoms, D-dimer level ≥0.75 mg/L were decreased (all P < 0.05). Multivariate Cox regression analysis showed that D-dimer ≥0.75 mg/L was an independent risk factor for OS of DLBCL patients ( HR=0.368, 95% CI 0.144-0.944, P= 0.038). Conclusion:The level of D-dimer can be used as a clinical indicator to judge the prognosis of DLBCL patients, and the prognosis of patients with high D-dimer level is poor.

Objective To explore the MRI diagnosis characteristics of reversible splenial lesion syndrome (RESLES).Methods The clinical and imaging data of 12 cases of RESLES was analyzed retrospectively.MRI plain scan and DWI of brain were performed in all the cases.Apparent diffusion coefficient (ADC) value was obtained through post-processing function.Results 8 of 12 cases were children and 4 were adults.The splenium of corpus callosum of 12 cases showed round lesions,with slightly long T1 and slightly long T2 signal on MRI,high signal on DWI,and low signal on ADC map.The mean value of ADC of 12 cases was about 0.43× 10-3 mm2/s.The MRI reexamination was made after treatment in 12 cases,which showed the lesion of splenium of corpus callosum disappeared,and clinical syndromes were improved.Conclusion The MRI manifestation of RESLES is characterized by solitary lesion.The ADC value could accurately reflect the molecular diffusion information of the lesion.

At present, there are few treatment protocols with limited efficacy for relapsed and refractory non-Hodgkin lymphoma (NHL). Histone deacetylase inhibitors (HDACi) exert anti-tumor effects by inhibiting the activation of histone deacetylase (HDAC) and regulating gene expression. HDACi alone or combined with other anti-tumor drugs have shown good efficacy in the treatment of relapsed and refractory NHL. This article reviews the progress of HDACi in the treatment of NHL.