Diffuse large B-cell lymphoma is the most common histology of non-Hodgkin lymphoma and is composed of clinically and pathologically heterogeneous group.The ESMO clinical practice guidelines stratified the diseases according to age,age-adjusted IPI and feasibility of dose-intensified approaches.While the regimens suggested by ESMO are almost the same:six to eight cycles of chemotherapy with CHOP combined with rituximah.This article discussed the inadequacies of the guideline according to the recent clinical and pre-clinical studies and the authors' personal experiences.Four deficiencies are outlined:new prognostic factors are not included for the stratification,no therapy adjustmett was advised according to the response,overload therapy for the very-low risk patient,and insufficient therapy for the young,high-risk patients.

Objective To investigate the relationships of HGF , c-Met expression and clinicopathological factors with liver metastasis of gastric cancer. Methods The tissues of primary tumors and corresponding liver metastasis were collected to detect the expression of HGF and c-Met by immunohistochemistry. Results The positive rates of HGF in the experimental group and the control group were 68% and 60%, respectively , with significant differences between two groups. The positive rates of c-Met of the two groups were 86% and 68%, respectively, with a significant difference between two groups. Lymph node metastasis, high expression of HGF and c-Met were significantly associated with liver metastasis of gastric cancer. The depth of invasion of bowel wall and degree of differentiation were not associated with the liver metastasis of gastric cancer. Conclusion High expressions of HGF and c-Met are closely associated with the liver metastasis mechanism of gastric cancer. The c-Met might be a useful indicator of liver metastasis in patients with gastric cancer.

Great advances have been made recently in the therapy of chronic lymphocytic leukemia due mainly to the application of novel agents. In the 58th American Society of Hematology Annual Meeting, the latest outcomes of many clinical studies have been reported. The present article will review the reports and focus on the following studies on chronic lymphocytic leukemia (CLL): the long-term therapeutic outcome of BTKi and the result of combination therapy of BTKi with other agents; the short-term result of bcl-2 inhibitor in CLL; the efficacy of maintenance therapy with lenalidomide in CLL patients; CD19-CAR T-cell therapy achieved good response. Traditional immunochemotherapy with combination of fludarabine, cyclophosphamide and rituximab is still the first-line option for fit patients through long-term follow-up. The allogeneic stem cell transplantation remains a curative strategy for CLL but with stricter indication.

Marginal zone lymphomas include three subgroups of lymphoma,with differences on etiology,pathogenesis,molecular cytogenetics,prognosis,as well as involved sites.Based on the reports from the latest ASH annual meeting,the present article introduces the uptodate understanding on the three subtypes of MZL.The recent advances on etioloty,pathogenesis,diagnosis and differential diagnosis were reviewed.

0.50).ConclusionsThe use of high-frequency electrotome significantly increases the postoperative perineal complications. The packing of greater omentum and perineal electromagnetic wave irradiation reduce the occurrence of the side effects.

The chronic lymphocytic leukemia cells are not only tumor cells, but also immune cells. Dysfunction of these tumor cells can induce many kinds of autoimmune diseases, which mainly are hematological complications. The clinical manifestations involve decreased amount of erythrocytes, platelets, or leukocytes. The pathogenesis of such complications is not very clear. Misdiagnoses and missed diagnoses often occur. Generally, the treatment protocols are similar to those of primary autoimmune diseases. The main concerns are how to give considerations to both chronic lymphocytic leukemia and autoimmune diseases simultaneously.

Objective To study the X-ray findings and clinical factors of the neonatal necrotizing enterocolitis (NEC)and to im-prove the detection rate of neonatal NEC-especially early lesions.Methods To retrospectively analyzed the plain abdominal radio-graphy images and clinical data of the 21 cases with confirmed neonatal NEC by clinical and surgical diagnosis.Results The X-ray findings of neonatal NEC:stageⅠ:10 cases showed the changes in intestinal motility and the interval thickness between the intestine≤2 mm;stageⅡ:① 4 cases showed the interval thickness between the intestine > 2 mm;② 4 cases showed the pneumatosis of the intestinal wall;③ the pneumatosis of the portal vein were three cases;stage Ⅲ:① 3 cases showed seroperitoneum;② pneumoper-itoneum were three cases.18 cases (85%)were the premature infan;1 6 of 21 cases NEC were the low birth weight;neonatal re-spiratory distress syndrome,infection,pneumonia,sepsis,and mechanical ventilation therapy are important risk factors of NEC. Conclusion X-ray findings has characteristic signs in the neonatal NEC.At the early of NEC,it is very important to make the correct diagnosis need combine X-ray performance with the clinical manifestations and risk factors for,with the necessary dynamic follow-up review in the clinical treatment and prognosis.

Objective To investigate the diagnosis and treatment of sequential diffuse large B-cell lymphoma (DLBCL) after peripheral T-cell lymphoma (PTCL).Methods A case with sequential DLBCL after PTCL was reported,and the characteristics and responses of this case were analyzed.The previous literature was reviewed in order to explain the mechanism and prognosis of such type of disease.Results This patient was diagnosed as PTCL not otherwise specified (PTCL-NOS) definitely,but after a period of treatment,DLBCL was developed as a second tumor.The characteristics and onset interval were just similar to those described in the literature,in which the mechanisms were mentioned as common effects of tumor cell,microenviroment and therapies.This patient got effects through the initial treatment,but considering the poor outcome by former researchers,the prognosis needed to be closely followed up.Conclusion Sequential development of EBV-unrelated DLBCL after PTCL-NOS is very rare,and the mechanism,therapy and prognosis need further investigation.

Objective Using Eclipse and Pinnacle3 V 7.4f treatment planning sytems (TPS) for dose calculation of the CT images of simulation phantom,patients and homogeneous organization phantom,to compare the differences between the two TPS for the calculation of non-uniform organizations.Methods For the CT images of simulation phantom,patients and homogeneous organization phantom,the calculating results between the two TPS were compared,including the common used clinical indexes of V20 and V30 of the lung,D95 of the planning target volume,the doses of the ISO and eight points of interest inside ISO slice.Resuits For simulation phantom and patients,although the calculating differences of the isocenter doses between the two TPS were small,the differences of other indicators were large.For example,when using secondary collimator irradiation,the maximal D95 difference of planning target volume reached 10.17%for patients and 4.64%for simulation phantom.When using muhileaf collimator irradiation,the maximal D95 difference reached 10.74%for patients and 5.66%for simulation phantom.Sometimes the dose differences of points 1-4 at the edge of planning target volume were more than 10%.In addition,the V30 differences of the lung were large too.But for the homogeneous organization phantom,the calculating differences were small.Conclusions The calculating differences between the two TPS are less for simulation phantom than for patients,and more for simulation phantom and patients than for homogeneous organization phantom.

Objective: To evaluate the clinical value of 18F-FDG PET/CT in diagnosing the recurrence or metastasis of the postoperative patients with gastrointestinal malignant tumor. Methods: Sixty-eight postoperative patients with gastrointestinal malignant tumor were studied with 18F-FDG PET/CT, and serum CEA and CA19-9 were assayed. Results: Thirty-seven patients were found to be recurrent or metastatic. The sensitivity and specificity of PET/CT detection were 97.3% and 96.8%,and the positive rates of PET/CT combined with CEA and CA19-9 were 100% and 97.8%.Conclusion: PET/CT has a higher sensitivity and specificity than tumor marker detection in assessment of recurrence and metastasis.