Rituximab is the first monoclonal antibody that has been approved for the treatment of lymphoma. Rituximab has shown significant efficacy in the treatment of B-cell non-Hodgkin's lymphomas, such as diffuse large B-cell and follicular lymphomas. Maintenance therapy with rituximab has further improved the prognosis in patients with follicular lymphoma. These patients responded to induction treatment. This antibody treatment has been recommended in treatment guidelines. The treatment strategy for lymphoma has continuously improved. Recent studies focused on how to improve the definition of the indication for maintenance therapy and how to optimize the current maintenance regimens. In this review, we summarized the main studies and the most recent advances on ritux-imab maintenance therapy in patients with lymphoma.

Objective To study the subclavian artery angiography for hemoptysis and its clinical value.Methods Thirty-eight cases of hemoptysis undertook subclavian artery angiography after embolization of bronchial arteries and branches of thoracic aorta. Group A: 4 recurrent cases underwent subclavian artery angiography (unilateral: n =2, bilateral: n =2). Group B: 16 cases underwent subclavian artery angiography according to the manifestation on X-ray and CT (right: n =10, left: n =6). Group C: 18 cases underwent bilateral subclavian artery angiography.Results of subclavian artery angiography were divided into three classes: normal(-),chaotic and hyperplasia of small branchi vessels(+),obviously bleeding (++).Some of the obviously bleeding cases were embolized and analysed for clinical efficacy and complications. Results Bleeding cases accounted for 63.2%(24/38)and bleeding subclavian arteries accounted for 50%(29/58), including(++):37.9%(22/58) and(+): 12.1%(7/58). Positive rate of chronic fibro-cavitary pulmonary tuberculosis was the highest. Bleeding sites were coincided with lung lesions. Twelve cases were embolized with the immediate cessation rate of hemoptysis reaching 100%. Eight cases with long-term follow-up showed 5 cured, 1 with significant effect and 2 recurrent. The complications occurred with fever, vomiting, chest pain, hiccup and dyspnoea.Conclusions Subclavian artery angiography has important clinical value in artery embolization for hemoptysis, especially for lesions in the upper lobes of lungs and with more fruitful result for chronic fibro-cavitary pulmonary tuberculosis.

ObjectiveTo analyze the CT appearances of primary pulmonary non-Hodgkin lymphoma(PPNHL)in order to improve its diagnosis.MethodsCT manifestations of 19 cases with PPNHL confirmed by pathology and clinical follow-up were retrospectively analyzed.ResuitsNodules 7 cases and masses 8 cases in PPNHL were ill-defined and markedly enhanced,in which air bronchogram was commonly seen.Muhiple patchy areas distributed in the bilateral lungs were found in 9 cases.Consolidation 7 cases was lobar and markedly enhanced,in which air bronchogram was commonly seen.Interstitial change manifested as bilateral diffuse ground-glass opacities and reticular shadow was found in 1 case.Mixed imaging manifestations were detected in 10 cases.Pleural effusion 4 cases was uncommon.Conclusion CT manifestations of PPNHL are varied,but some specific imaging features still exist,CT examination combined with clinical manifestations is helpful for the diagnosis of PPNHL.

ObjectiveTo determine the effectiveness of endovascular embolization in patients with cryptogenic massive hemoptysis who were all long-term smokers.Methods Aortography and subclavian artery angiography were performed in 21long-term smokers with cryptogenicmassive hemoptysis.Transarterial embolization (TAE) was performed in patients with detectable pathologic systemic arteries.The angiographic findings were reviewed and the clinical and follow-up CT results were observed.ResultsThe pathologic systemic arteries were all bronchial arteries (BAs) and thirty-five arteries were involved.The angiography demonstrated peripheral hyperplasia in all BAs,with 24 pathologic BAs supplying the right lung and 25 supplying the upper lobes.In thirty-five BAs,24 showed hypertrophy and 11 were normal.TAE of the pathologic BAs was successfully performed and cessation of bleeding was achieved in all patients.During follow-up,one patient had episodic bloody sputum after embolization and no recurrence in all patients.The follow-up CTdemonstratednoadditionalabnormalitybesidespre-existingpulmonaryemphysema.Conclusion Cryptogenic massive hemoptysis in long-term smokers efficiently treated by endovascular embolization of the responsible bronchial artery.

This study aimed at comparing the precise powder decoction pieces and market raw TCM slices of P.cacumen over the decocting quality.ITS2 sequence was adopted as a DNA barcode to identify P.cacumen.The chemical composition of the medicinal materials was characterized by HPLC fingerprints for the evaluation of the similarity of precise powder decoction pieces and market TCM slices.The concentrations of quercitrin were determined using UPLC,and the characteristic common peaks were identified.In addition,the extraction efficiency between the market TCM slices and the precise powder decoction pieces was also compared by standard decoction method.It was found that P.cacumen was accurately identified by ITS2 sequences.HPLC fingerprints showed that the extraction efficiency and similarity of the precise powder decoction pieces increased compared with the market TCM slices.However,the extraction yield rate of the precise powder decoction pieces was improved by 20％ increased in accordance with the standard decoction method,while the contents of the index component,quercitrin,presented rare increase and the decocting rates of the other chemical components little change in the study.In conclusion,it was indicated that precise powder decoction pieces improved the extraction efficiency and uniformity in comparison with TCM slices.

This study aimed at evaluating the quality of precise powder decoction pieces (PPDP) of E.Folium (EF) compared with the traditional commercial slices by chemical fingerprint methods and DNA molecular identification technology.Different specifications of PPDP were prepared,and their dry extract contents were in contrast with that of commercial slices.The slices of EF were identified using ITS2 and psbA-trnH sequences.Three batches of commercial slices were collected,and the content uniformity,fingerprint and similarity evaluation before and after the mixing and pulverization were detected by HPLC-DAD and DNA sequence alignment.It was found that the paste rate of PPDP was slightly higher than that of the traditional commercial slices.The dissolution of chlorogenic acid of PPDP was higher than that of the traditional commercial slices.RSD of inter-assay dissolutions of chlorogenic acid of commercial slices was 15.56％,which was reduced to 6.82％ after mixing and preparing into PPDP.The fingerprints showed that the similarity of the PPDP of EF was elevated with the inceases of 10 marketed common peaks.The PPDP of EF was accurately identified by ITS2 and psbA-trnH sequences.In conclusion,compared with traditional commercial slices of EF,the PPDP apparently improved the dissolution rate and the quality uniformity,demonstrated that the boiled powder of CRP achieved obvious clinic advantages.

This study aimed at investigating the drug preparation of precise powder decoction pieces (PPDP) system,Fallopia multiflora radix preparata (FMRP) was employed in this study.Different specifications of PPDP were prepared,their extract rates were in contrast with the original pieces.Compared the quality uniformity of three batches between FMRP original slices and its PPDP extraction,the similarity of the chemical fingerprints was evaluated,and the contents of common peaks and quality uniformity were compared by relative peak areas.ITS2 sequence was taken as a DNA barcode to identify F.multiflora radix (FMR).As a result,the extract rate of PPDP was 2.5 times as much as the original slices.The average content of stilbene glucoside from the three original slices and the PPDP extraction were 3.56 ± 2.61 and 13.23 ± 0.37 mg·g-1,respectively;while the RSD were 73.28％ and 2.82％.The similarity of the fingerprints of the PPDP extraction was almost the same as that of the original slices,but the content and the uniformity of the common peaks of the PPDP extraction were significantly improved.Thus,FMR was accurately identified using ITS2 sequences.It was concluded that the PPDP considerably improve the decocting rate and quality uniformity,indicating that PPDP could save resources and improve the clinical efficacy.

Purpose To explore the value of window width adjustment in diagnosing the invasiveness of lung adenocarcinoma manifested as ground glass opacities on high-resolution CT, and to provide guidance for the diagnosis of lung adenocarcinoma in different types. Materials and Methods The preoperative CT data of 102 preinvasive lesions and 107 invasive lesions of lung adenocarcinoma were analyzed retrospectively. Among 102 cases of preinvasive lesions, 25 were atypical adenomatous hyperplasia (AAH), 77 were adenocarcinoma in situ (AIS). Among 107 cases of invasive lesions, 78 were minimally invasive adenocarcinoma (MIA), and 29 were invasive adenocarcinoma. The lesions were ground glass opacity (GGO) on lung window while were invisible on mediastinal window. The window width was adjusted constantly until the lesions were invisible with the fixed mediastinal window level (40 HU). When the lesions became invisible, the window width was compared and the best cut-off was found on ROC curve in the two groups. Results The window width of lesions between preinvasive lesions and invasive lesions was different (Z= - 6.203, P<0.05). Window width was a good indicator for the invasiveness of pulmonary adenocarcinoma (area under the ROC was 0.748, P<0.05), and the window width of 1303 HU was the best cut-off for preinvasive lesions and invasive lesions (sensitivity was 56.9%, specificity was 86.0%. Conclusion Window width may be useful for the diagnosis of the invasiveness of the GGO of lung adenocarcinoma on HRCT. The lesion disappearing when the window width is larger than 1303 HU is more likely to be preinvasive; while the lesion disappearing when the window width is smaller than 1303 HU is more likely to be an invasive one.

Objective To determine the effectiveness of endovascular embolization through pulmonary artery access in patients with refractory massive hemoptysis in whom systemic artery (SA)embolization is ineffective or contraindicated. Methods A total of 102 patients were treated with SA embolization for hemoptysis. Of the 102 patients, 6 patients had severe persistent hemoptysis despite complete SA embolization and 1 patient had severe hemoptysis following complete bronchial artery embolization and other SA embolization was contraindicated. The underlying diseases were chronic cavitary pulmonary tuberculosis (n = 3), chronic cavitary pulmonary tuberculosis complicated with aspergilloma (n=1), tuberculous bronchiectasis (n=1), severe necrotizing pneumonia (n=1) and bronchiectasis complicated with pneumatocele (n=1). The findings of SA angiography, main pulmonary angiography and selective pulmonary angiography were analyzed. Endovascular embolization was performed in patients with the detectable pathology in PA and the clinical results were observed. Results The findings of SA angiography showed bronchopulmonary shunting in all cases, and pseudoaneurysm of PA in 2 cases and hypertrophy of peripheral PA in 2 cases. The main PA angiography demonstrated pseudoaneurysm of PA in 1 case and hypoperfusion of the diseased PA in other case. The selective PA angiography demonstrated pseudoaneurysm of PA in 4 cases (1 case with extravasation of constrast medium) and hypertrophy ofperipheral PA in 2 cases. Coil embolizations of the pathologic PA were successfully performed and bleeding ceased in all patients. During follow-up, 1 patient had episodic bloody sputum after embolization, and 2 died day 6 and 15 of severe infection and respiratory failure and the remaining patients were all stable.Conclusions In patients with refractory massive hemoptysis after systemic embolization, the possibility of PA pathology, especially pseudoaneurysm of PA should be considered. Selective pulmonary angiography is necessary to demonstrate the pathology in PA. Endovascular management of the pathologic PA appears to be a safe and effective treatment.

Objective To explore the CT findings of mucoepidermoid carcinoma (MEC) of the tracheobronchial tree and improve the diagnostic accuracy. Methods The CT images, histopathological and clinical data in 24 patients with pathologically proved MEC of the tracheobroncbial tree were retrospectively analyzed. Results The clinical symptoms included cough, sputum, fever, wheezing, chest pain and hemoptysis. The patient was proved to be low-grade (n=19) and high-grade (n=5) MEC histopathologically. One lesion was located in trachea, 6 in main bronchus, 12 in lobar bronchus and 5 in segmental, subsegmental and distal bronchus. The tumor presented as no-invasive endotracheobronchial well-defined round-like nodule (n=13, locating in lobar and higher bronchus) and columnar sharp (n=3, locating in main bronchus), or intra-and-extraluminal well-defined round-like nodule or mass (n=6, locating in lobar and lower bronchus) and irregular mass with invasive pattern (n=2, high-grade type). The density of lesion was similar to the muscule and the calcification within lesion was showed in 4 patients on non-enhanced CT. The lesion had marked enhancement in 17 patients on enhanced CT. Obstructive changes were found in 20 patients. Conclusion MEC of the tracheobronchial tree is usually low-grade malignancy and locates in main and lobar bronchus with no-invasive well-defined airway mass, marked enhancement and calcification on CT.