Objective To explore the development and validation of a prediction model for severe communi-ty-acquired pneumonia in adults based on peripheral blood inflammatory indicators.Methods Venous blood samples of 204 community-acquired pneumonia in adults patients admitted to 7 hospitals in Chongqing area from April 2021 to August 2022 were collected to detect C-reactive protein(CRP),peripheral white blood cell count(WBC),neutrophil to lymphocyte ratio(NLR),cytokines,lymphocyte subgroups and neutrophil CD64 index.All of patients were divided into a training group and a validation group according to the time of admis-sion.Univariate and multivariate Logistic regression were used to analyze the data of the training group,the characteristic factors of severe progression for pneumonia were selected to construct the nomogram model,and the data of the validation group was used to verify the model.The receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA)were used to evaluate the prediction ability of the model for severe community-acquired pneumonia in adults.Results Logistic regression analysis showed that age,CRP,WBC,interleukin(IL)-4/interferon gamma ratio and IL-6/IL-10 ratio were independent risk factors for severe community-acquired pneumonia in adults.The area under the ROC curve of the nomogram model in the training group and the validation group was 0.893 and 0.880,respectively.The calibration curve and DCA results shown that the model had a good prediction effect for severe community-acquired pneumonia in adults.Conclusion The inflammatory indicators included in this model are simple and easy to obtain clinically.This model with good differentiation and accuracy,it can be used as a practical tool to predict severe community-ac-quired pneumonia in adults,and has certain clinical application value.

Objective:To investigate the clinical features,differential diagnosis and treatment of intravascular NK/T cell lymphoma.Methods:The clinical data and diagnosis and treatment process of 2 patients with intravascular NK/T cell lymphoma admitted to Chongqing University Cancer Hospital were retrospectively analyzed, and related literatures were reviewed.Results:Both patients were initially presented with cutaneous symptoms. Patient 1 was diagnosed with intravascular NK/T cell lymphoma, and received 4 courses of programmed-death receptor 1 (PD-1) inhibitor toripalimab + P-Gemox (pegaspargase + gemcitabine + oxaliplatin) regimen, 1 course of PD-1 + ME (toripalimab + mitoxantrone + etoposide) regimen and then underwent autologous hematopoietic stem cell transplantation; patient 2 was diagnosed with intravascular NK/T cell lymphoma involving the nasal cavity, and received 4 courses of P-Gemox regimen, and then received autologous hematopoietic stem cell transplantation in the other hospital. Both patients achieved good therapeutic efficacy.Conclusions:Intravascular NK/T cell lymphoma is very rare, frequently involving the skin and central nervous system. Intravascular growth of tumor cells derived from NK cells is the key point of diagnosis and differential diagnosis. P-Gemox regimen and hematopoietic stem cell transplantation could bring better curative effect.