OBJECTIVETo photoelastically investigate the difference in load distribution of Tension More (TM) implants with different conical angle designs.

METHODSThe following five groups of implants of different conical angles were designed: cylinder implant, upper 1/3 TM implant (taper length of 3 mm); 1/2 TM implant (taper length of 5 mm); lower 1/3 TM implant (taper length of 7 mm); and bottom TM implant (taper length of 10 mm). The implants were centrally located in individually photoelastic models consisting of a simulated trabecular bone and a 1 mm-thick layer of cortical bone. Vertical and 45° oblique static loads were applied at the center of the superstructures. The resulting stresses were monitored photoelastically and recorded photographically. RESULTS With vertical loading, the cylinder implant showed higher stress levels in the cortical bone and trabecular bone than the upper 1/3 TM implant, 1/2 TM implant, and lower 1/3 TM implant. The four groups of TM implants showed lower stress levels in the cortical bone than the cylinder implant under oblique loads. The least favorable stress concentration in cortical bone was observed in the upper 1/3 TM implant under vertical and oblique loads.

CONCLUSIONTM implants of rational conical angle designs seem to be effective in stress distribution. For all designs and load directions, the upper 1/3 TM implant is the most favorable around the crest.

Bone and Bones ; Dental Implants ; Stress, Mechanical

Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Humans ; Lymphoma, Follicular ; drug therapy ; Rituximab

Objective: To investigate the effect of 1q21 amplification (1q) on the therapeutic response and prognosis of bortezomib(Btz) in the treatment of newly diagnosed multiple myeloma (MM) patients. Methods: A total of 180 newly diagnosed MM were included for analyses of clinical characteristics, cytogenetics, objective response rate (ORR), progression-free survival (PFS) and overall survival (OS), retrospectively. Gene expression profiling (GEP) was analyzed using publicly available R2 platform. Results: ① In 180 patients, 1q was found in 51.1% cases. Of them, 174 patients had complete follow-up data, including 88 cases with 1q and 86 without 1q (non-1q). ②Incidence of 1q was positively associated with percentage of IGH rearrangement (72.2%, P=0.017) and 1p deletion (1p) (27.8%, P=0.040). ③ The median PFS was 15.0 and 20.3 months for the 1q group and non-1q group, and the median OS was 29.4 and 44.0 months, respectively. Both PFS and OS of 1q group was significantly shorter than those of the non-1q group (P=0.029 and 0.038, respectively). Multivariate analysis further revealed that 1q was an independent prognostic factor for both PFS (HR=1.910, 95% CI 1.105-3.303, P=0.020) and OS (HR=2.353, 95% CI 1.090-5.078, P=0.029). ④ In 91 evaluable cases with 1q, very good partial remission (VGPR) rate was higher after treatment with Btz than those without Btz (62.1% vs 40.0%, P=0.032). Of note, the patients with 1q who received auto-HSCT after induction with Btz had significantly longer PFS than those without auto-HSCT (19 months vs 13 months, P=0.048). ⑤GEP analysis revealed that 1q21 amplification predominantly up-regulated expression of >50% genes within 1q21 region, and also altered expression of 28% genes in chromosome 1 and 10% genes in whole genome, particularly related to DNA repair and cell cycle. Conclusions 1q is an independent adverse prognostic factor in patients with newly diagnosed MM. It is often associated with 1p deletion and IGH rearrangement. Patients with 1q respond well to Btz-based regimen, but they fail to gain long-term benefit from this treatment itself. However, auto-HSCT following Btz induction might improve survival of patients with 1q, suggesting a potential strategy to treat this high-risk subset of MM. GEP analysis warrants further attention in understanding the mechanisms underlying the high-risk of 1q.

Objective: To investigate the clinical features, diagnosis, occurrence sequence and clonal origin of chronic lymphocytic leukemia complicated with multiple myeloma. Methods: The diagnosis and treatment of one patient with multiple myeloma and chronic lymphocytic leukemia who was admitted to the First Hospital of Jilin University in May 2018 was retrospectively analyzed, and the related literatures were reviewed. Results: This patient began with lumbosacral pain, and he was diagnosed as chronic lymphocytic leukemia complicated with multiple myeloma after bone marrow aspiration, flow cytometry, and blood and urine immunofixation electrophoresis. It is recommended that Rd (lenalidomide + dexamethasone) or MPV (melphalan + prednisone + bortezomib) regimen, but the patient did not receive chemotherapy and died of infectious diarrhea 1 month later. Conclusions The occurrence of multiple myeloma and chronic lymphoblastic leukemia may originate from the same clone or different new clone. It is very rare that multiple myeloma and chronic lymphoblastic leukemia can co-occur. Therapeutic options tend to be more aggressive multiple myeloma-based regimen.

Objective To discuss ⁷Be and a 77.2 keV full-energy peak with short half-life found in the water sample from the 3D water phantom of a proton therapy system. Methods We measured the water sample from the 3D water phantom of a proton therapy system according to Determination of Radionuclides in Water by Gamma Spectrometry (GB/T 16140—2018). Results The activity concentration of ⁷Be in the water sample was 1.30 × 10¹ Bq·L⁻¹ on December 24, 2018; 4.3 × 10¹ Bq·L⁻¹ on March 22, 2019; and 1.41 × 10¹ Bq·L⁻¹ at the time of sampling on December 19, 2018. On December 24, 2018, the net peak area of the 77.2 keV full-energy peak in the sample was 683 ± 45, and the measurement time was 26123.02 s; on March 22, 2019, the net peak area decreased to the background level of 194 ± 49, and the measurement time was 86400.00 s. Conclusion In the 3D water phantom of the proton therapy system, ⁷Be can be generated from the spallation reaction between high-energy neutrons and oxygen in water. In addition, we find a full-energy peak at 77.2 keV with short half-life. The activity concentration of ⁷Be in the water sample is lower than the exemption level, but the activity concentration at sampling may not be the maximum activity concentration in the process of quality control. The inductive radionuclide ⁷Be produced in the 3D water phantom should be identified and properly evaluated in the assessment of occupational radiation hazards of proton therapy system.

OBJECTIVEA prospective, multicenter and non-interventional prospective study was conducted to evaluate the clinical features of rituximab combined with chemotherapy (R-Chemo) as first-line treatment on newly diagnosed Chinese patients with diffuse large B-cell lymphoma (DLBCL).

METHODSThis was a single arm, prospective, observational multicenter and phase IV clinical trial for 279 patients, who were newly diagnosed as CD20-positive DLBCL from 24 medical centers in China 2011 and 2012, no special exclusion criteria were used. All patients received rituximab based R-Chemo regimes, such as R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisolone) and other regimes as the first-line treatment. The treatment strategies were determined by physicians and patients without detailed description for treatment course, dose, interval time and examination. Clinical response and safety of all patients were investigated in 120 days after completion of last dose of rituximab.

RESULTSOf 279 patients, 258 with stage I-IV who received at least 1 cycle of rituximab treatment and completed at least one time of tumor assessment were enrolled into intention-to-treat analysis, including 148 male and 110 female. The median age of all patients was 57.2(12.8-88.4) years. ECOG performance statuses of 0 or 1 were observed in 91.1% of patients, international prognostic index levels in the low-risk and low-middle-risk groups in 76.4% of patients, the tumor diameters smaller than 7.5 cm in 69.0% of patients. All patients received 6 median cycles of R-Chemo treatment every 24.4 days. R-CHOP treatment was shown to improve the clinical response with overall response rates of 94.2%. Common adverse events included anemia, marrow failure, leukopenia, thrombocytopenia, digestive diseases, infection and liver toxicity. All adverse events are manageable.

CONCLUSIONNon-interventional clinical trial of R-Chemo remains the standard first-line treatment for newly diagnosed patients with DLBCL in real clinical practice, which is consistent with international treatment recommendations for DLBCL patients. R-Chemo can provide the clinical evidence and benefit as the first-line standard treatment for Chinese patients with DLBCL.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; Male ; Middle Aged ; Prospective Studies ; Rituximab ; Treatment Outcome