Objective To analyze the clinical features of primary splenic lymphoma. Method Clinicopatholngie features of 29 patients with primary splenic lymphoma treated in Cancer Hospital, Chinese Academy of Medical Sciences from November 2000 to August 2008 were analyzed retrospectively. Results In this study 27 cases were confirmed to be non-Hodgkin's lymphoma (NHL), and 2 cases were of Hodgkin's lymphoma (HL). According to Ahmann's staging, 6 cases belonged to stage Ⅰ, 4 was stage Ⅱ, and 19 was stage Ⅲ. Twenty-six patients received spleneetomy, 2 cases did splenectomy plus pancreatic body and tail resection, and 1 case did spleneetomy plus partial gastrectomy. Postoperatively, 19 cases received chemotherapy, and 5 of the 19 patients received rituximab (Mabthera) treatment. One patient received radiotherapy for regional lymph node invasion. The median time of follow-up was 24 months (range, 2 -93 months). The l-year, 3-year and 5-year overall survival rates were 96%, 83% and 73%, respectively. The 1-year, 3-year and 5-year disease-free survival rates were 96%, 51% and 51%, respectively. Conclusions Primary splenic lymphoma is the most common malignant tumor of the spleen. Splenectomy combined with excision of invaded tissues or organs is important therapy for patients with primary splenic lymphoma. Comprehensive treatments including chemotherapy, radiotherapy and biotherapy are recommended after operation.

Objective To assess the feasibility and indications of local resection as an alternative to pancreaticoduedenectomy for the treatment of early stage ampullary cancer. Methods In this study,36 patients with an AJCC.stage pTl ampullary carcinoma were operated on between 1989 and 2009.Among those local resection was performed in 11 cases and pancreaticoduodenectomy in 25 cases.The main outcome measures were pre-and intra-operative diagnosis and staing,postoperative morbidity and mortality,recurrence.free and overall survival.Results Amp-llary cancerat early stageWas difficult to be diagnosed and staged before and during operation.It was at a much lower risk to perform local resection than pancreaticoduodenectomy.Postoperative complications were significantly lower in local resefion group than in pancreaticoduodenectomy group(P=0.031);whereas the postoperative hospital stay(P=0.254),perioperative mortality(P=1.000).disease-free survival(P=0:301)and long-term survival(P=0.289) were not statistically different between.the two groups. Conclusions Since accurate diagnosis and staginging of early ampullary cancer was diit3cult to establish perioperatively.local resection should be indicated forpoor risk pafients or those who refuse pancreaticoduedenectomy.

Objective:To investigate the effect of flap combined with 3D printed microporous titanium(tantalum)prosthesis in the treatment of lower extremity soft tissue defect with large bone defect.Methods:From January 2019 to December 2020, 2 patients with large soft tissue defects on dorsal foot together with large metatarsal bone defect and 4 patients with soft tissue defects of calf with large tibial bone defect were treated. The areas of soft tissue defect were 5.0 cm×8.0 cm-15.0 cm×10.0 cm. The length of the bone defect were 3.8 cm to 7.0 cm, 5.75 cm in average. In the first stage, metatarsal bone defect or tibial bone defect was filled with vancomycin blended bone cement, meanwhile, soft tissue defect was repaired with anterolateral femoral flap(ALTF) with vascular anastomosis in 2 cases of feet, and local fascia flap was trans-positioned in 4 cases of lower extremity defects. The sizes of repairing flap were 6.0 cm×8.5 cm-16.0 cm×11.0 cm. Two to 7 months after the initial surgery, the customer designed microporous titanium prostheses were used(5 cases with microporous titanium and 1 with microporous tantalum) to repair the bone defects. The wound healing, the integration of metatarsal and tibial fractures with 3D printed microporous titanium(tantalum) prostheses, and the walking condition were observed after surgery. The follow-up lasted from 6 to 25 months, with an average of 12.7 months.Results:The wound healing in 5 patients was good. The patients stood on the foot in 2 months after surgery, started to walk with the assistance of crutch in 3 months after surgery, and took walk without assistance in 5-6 months after surgery. Good osseous integration were achieved. One diabetic patient had infection of foot wound 3 months after surgery. After removal of microporous titanium prosthesis and replacement of vancomycin blended interstitial substance of bone cement, the wound healed and the patient resumed walking.Conclusion:It is an effective method to encourage the patients to take early ambulation after the surgery for lower extremity soft tissue defect with large bone defect that was repaired by a flap and 3D printed microporous titanium(tantalum)prosthesis. Further observations are required to investigate the long-term efficacy, and the reduction of prosthesis infection rate requires further exploration.

【Objective】 To investigate the effects of neutrophil-derived exosomes on skin wound healing. 【Method】 ① The venous blood was taken from 10 healthy volunteers to separate and purify neutrophils, and exosomes were prepared from neutrophil supernatants using differential centrifugation on Sepharose columns. ② The rat trauma model with full-thickness skin defect was prepared and randomly divided into three groups: control group, 50 μg/mL exosomes group, and 100 μg/mL exosomes group. The CCK8 test and the scratch test were used to determine the proliferation and migration of vascular endothelial cells, respectively, which was used to investigate the effects of neutrophil-derived exosomes on the formation of endothelial cell tubular structures in vitro. On day 7 and day 14 after surgery, the skin wound healing was observed and the wound healing rate in different treatment groups was compared. On day 14 after surgery, the wound tissues of each group were stained with HE and Masson to observe the arrangement of collagen fibers. 【Results】 ① Neutrophil-derived exosomes were round or oval vesicles with diameter about 100 nm. ② On post injury hour (PIH) 12, the scratch test suggested that wound healing rates in the three groups were close (P>0.05 ), while wound healing rate of 100 μg/mL neutrophil-derived exosomes in the treatment group was higher than that in the control group (P<0.01) and 50 μg/mL exosomes group (P<0.05) on PIH 24. On PIH 12, the result of CCK8 assay showed that 50 and 100 μg/mL exosomes groups had enhanced proliferative activity of vascular endothelial cells (P<0.01) and the results were still higher in both groups than in the control group on PID 24. The results of tube formation assay showed that neutrophil-derived exosomes could promote the formation of tubular structures of endothelial cells in vitro (P<0.01). ③ On day 7 and 14 after surgery, compared with the control group, the wound healing rates of the 50 and 100 μg/mL exosomes groups were higher (P<0.01). The wound healing rate of 100 μg/mL exosomes group was higher than that of 50 μg/mL exosomes group (P<0.01). Compared with the control group, the newly formed epidermis and dermis on the wound surface of the 100 μg/mL exosomes group were longer, the number of collagen fibers increased, and the arrangement direction was highly consistent on the 14 th day after surgery. 【Conclusions】 Neutrophil-derived exosomes can promote full-thickness wound healing in rats by promoting the proliferation and migration of new vascular endothelial cells and the formation of collagen fibrous.