Objective:To analyze the factors affecting delayed chemotherapy in children with Burkitt lymphoma (BL) and their influence on prognosis.Methods:Retrospective cohort study. Clinical data of 591 children aged ≤18 years with BL from May 2017 to December 2022 in China Net Childhood Lymphoma (CNCL) was collected. The patients were treated according to the protocol CNCL-BL-2017. According to the clinical characteristics, therapeutic regimen was divided into group A, group B and group C .Based on whether the total chemotherapy time was delayed, patients were divided into two groups: the delayed chemotherapy group and the non-delayed chemotherapy group. Based on the total delayed time of chemotherapy, patients in group C were divided into non-delayed chemotherapy group, 1-7 days delayed group and more than 7 days delayed group. Relationships between delayed chemotherapy and gender, age, tumor lysis syndrome before chemotherapy, bone marrow involvement, disease group (B/C group), serum lactate dehydrogenase (LDH) > 4 times than normal, grade Ⅲ-Ⅳ myelosuppression after chemotherapy, minimal residual disease in the interim assessment, and severe infection (including severe pneumonia, sepsis, meningitis, chickenpox, etc.) were analyzed. Logistic analysis was used to identify the relevant factors. Kaplan-Meier method was used to analyze the patients' survival information. Log-Rank was used for comparison between groups.Results:Among 591 patients, 504 were males and 87 were females, the follow-up time was 34.8 (18.6,50.1) months. The 3-year overall survival (OS) rate was (92.5±1.1)%,and the 3-year event-free survival (EFS) rate was (90.5±1.2)%. Seventy-three (12.4%) patients were in delayed chemotherapy group and 518 (87.6%) patients were in non-delayed chemotherapy group. The reasons for chemotherapy delay included 72 cases (98.6%) of severe infection, 65 cases (89.0%) of bone marrow suppression, 35 cases (47.9%) of organ dysfunction, 22 cases (30.1%) of tumor lysis syndrome,etc. There were 7 cases of chemotherapy delay in group B, which were seen in COPADM (vincristine+cyclophosphamide+prednisone+daunorubicin+methotrexate+intrathecal injection,4 cases) and CYM (methotrexate+cytarabine+intrathecal injection,3 cases) stages. There were 66 cases of chemotherapy delay in group C, which were common in COPADM (28 cases) and CYVE 1 (low dose cytarabine+high dose cytarabine+etoposide+methotrexate, 12 cases) stages. Multinomial Logistic regression analysis showed that the age over 10 years old ( OR=0.54,95% CI 0.30-0.93), tumor lysis syndrome before chemotherapy ( OR=0.48,95% CI 0.27-0.84) and grade Ⅲ-Ⅳ myelosuppression after chemotherapy ( OR=0.55,95% CI 0.33-0.91)were independent risk factors for chemotherapy delay.The 3-year OS rate and the 3-year EFS rate of children with Burkitt lymphoma in the delayed chemotherapy group were lower than those in the non-delayed chemotherapy group ((79.4±4.9)% vs. (94.2±1.1)%, (80.2±4.8)% vs. (92.0±1.2)%,both P<0.05). The 3-year OS rate of the group C with chemotherapy delay >7 days (42 cases) was lower than that of the group with chemotherapy delay of 1-7 days (22 cases) and the non-delay group (399 cases) ((76.7±6.9)% vs. (81.8±8.2)% vs. (92.7±1.3)%, P=0.002).The 3-year OS rate of the chemotherapy delay group (9 cases) in the COP (vincristine+cyclophosphamide+prednisone) phase was lower than that of the non-chemotherapy delay group (454 cases) ((66.7±15.7)% vs. (91.3±1.4)%, P=0.005). Similarly, the 3-year OS rate of the chemotherapy delay group (11 cases) in the COPADM1 phase was lower than that of the non-chemotherapy delay group (452 cases) ((63.6±14.5)% vs. (91.5±1.3)%, P=0.001). Conclusions:The delayed chemotherapy was related to the age over 10 years old, tumor lysis syndrome before chemotherapy and grade Ⅲ-Ⅳ myelosuppression after chemotherapy in pediatric BL. There is a significant relationship between delayed chemotherapy and prognosis of BL in children.

To investigate the clinical and pathological characteristics of duodenal-type follicular lymphoma (D-FL), and to deepen the understanding of Duodenal-type follicular lymphoma. The clinical symptoms, endoscopic features, pathologic features, immunophenotype, molecular pathological features and treatment follow-up of 18 D-FL patients diagnosed in Department of Pathology, Beijing Tiantan Hospital affiliated to Capital Medical University between January 2020 and July 2023 were summarized. A total of 18 patients with D-FL were included, including 10 males and 8 females. The median age was 49 (32-69) years respectively. Most of the patients were found during gastroenteroscopy or presented with the common gastrointestinal symptoms of stomach pain, acid reflux, vomiting and diarrhea. Most endoscopic findings were multiple small gray and white polyposis. In the pathological morphology, the mucous layer and submucous layer showed lymphoid follicular structures with full and strained follicles. The immunophenotype showed that the tumor cells strongly expressed CD20 and BCL2 and had low proliferation activity. Immunoglobulin clonal analysis of 1 case showed IgK monoclonal rearrangement (1/1). FISH showed 1 case of BCL2 gene rearrangement (1/3). All patients did not receive targeted chemotherapy and adopted a wait-and-see strategy. Median follow-up was 12 (2-34) months. This study shows that D-FL is an indolent lymphoma, which tends to occur in the duodenum and has a good prognosis.

Objective:To study the urinary iodine levels of children in Jiangxi Province and provide a basis for prevention and treatment of iodine deficiency disorders and scientific iodine supplementation.Methods:From March to July in 2022, a systematic sampling method was used in 99 counties (cities, districts, abbreviated as counties) in Jiangxi Province. One township (street) was selected from each county in five directions: east, west, south, north and middle. One primary school was selected from each township (street), and 40 non boarding children aged 8 - 10 (half male and half female) were selected from each primary school. One random urine sample was collected to test urinary iodine, and the distribution of urinary iodine in different regions, genders, and ages were compared.Results:A total of 19 842 urine samples were collected from children, with a median urinary iodine level of 181.90 μg/L. The median urinary iodine levels of children in different cities ( H = 1 014.05, P < 0.001), genders ( Z = 6.44, P < 0.001) and ages groups ( H = 29.82, P < 0.001) were compared, and the differences were statistically significant. Conclusion:The urinary iodine level of children in Jiangxi Province is at an appropriate level, but the distribution of urinary iodine is uneven among different regions, genders, and ages, indicating that scientific and precise iodine supplementation is necessary for the prevention and treatment of iodine deficiency disorders.

Objective:To develop a laparoscopic surgery flushing waste liquid collection device,to collect a large amount of waste liquid generated when flushing fluid was used in urological laparoscopic surgery.Methods:The structure of the laparoscopic surgical flushing waste collection device was composed of a lifting mechanism,a liquid waste collector and a liquid waste discharger.The height of the waste liquid collector can be adjusted by changing the height of the lifting mechanism to suit the body position of the patient and the needs of the surgeon.The waste liquid generated during the operation can be led to the waste liquid collection tank through the collection trough,and then the waste liquid is discharged to the non-operative area container through the discharge tube.A total of 80 patients who underwent transurethral resection of prostate in the operating room of The Second Affiliated Hospital of Hainan Medical University from June 2022 to December 2022 were selected and divided into observation group and control group by random number table method,with 40 cases in each group.In the observation group,a brain protective film with an open bottom was used to collect the waste fluid and specimens in combination with the laparoscopic surgical flushing waste collection device.In the control group,samples were collected by knotting and perforating the lower end of brain protective membrane and waste fluid was collected by ordinary bucket.The incidence of intraoperative flushing fluid contamination of the ground environment and the time taken for waste fluid to be drawn out of the surgical area were compared between the two groups,and the intraoperative specimen collection rate was calculated.Results:The total incidence of overflow of flushing waste fluid and contamination of the ground environment in the observation group was 7.5%,which was significantly lower than that of the control group(27.5%),the difference was statistically significant(x2=6.135,P<0.05).The operation time of observation group was better than that of control group,the difference was statistically significant(t=7.966,P<0.001).The collection rate of surgical specimens in the observation group was higher than that in the control group,the difference was statistically significant(x2=6.135,P<0.05).Conclusion:The laparoscopic surgery waste liquid collection device can meet the requirements of surgical waste liquid collection,which simple to operate,time-saving and labor-saving,can reduce the environmental pollution of the surgical ground,and improve the collection rate of surgical specimens.

Objective:To investigate the clinicopathological and molecular genetic characteristics and prognosis of patients with diffuse large B-cell lymphoma (DLBCL).Methods:The clinicopathological data of 152 DLBCL patients receiving consultation and routine physical examination in Peking University Third Hospital and Peking University School of Basic Medicine from January 2008 to December 2015 were retrospectively analyzed. Immunohistochemistry was used to detect the expressions of CD10, bcl-6, MUM1, GCET1, FOXP1. EB virus encoded small RNA (EBV-EBER) was detected by using in situ hybridization. The aberrations of bcl-2, bcl-6 and c-myc genes were detected by using fluorescence in situ hybridization (FISH) to screen double-hit lymphoma (DHL). Kaplan-Meier method was used to make survival analysis.Results:Among 152 cases of DLBCL, the ratio of male to female was 1.49:1, the median age of onset was 59 years (7-90 years), and 79 cases (52.0%) were primary lymph nodes. The median overall survival (OS) time of all cases was 16 months (1-101 months). The 1-year, 3-year and 5-year OS rates were 70.2%, 44.7%, 30.3%, respectively. The OS of R-CHOP treatment group was better than that of CHOP treatment group and untreated group ( P = 0.001). Among all 137 patients receiving double-hit histochemistry score (DHS), there were 56 cases with 0 score, 57 cases with 1 score, 24 cases with 2 scores; and the difference in the OS of different DHS score groups ( P = 0.311). FISH detection showed that among 29 cases achieving results of c-myc gene detection, there were 2 cases of splitting gene and 3 cases of gene amplification; among 26 cases achieving results of bcl-2 gene detection, 2 cases had bcl-2 gene amplification; among 26 cases achieving results of bcl-6 gene detection, 2 cases had bcl-6 gene amplification and 3 cases had splitting gene. It was found that myc and bcl-2 genes were amplified simultaneously in 1 case, accompanied with bcl-6 gene splitting, which was called triple-hit lymphoma. In DHS 0-score group, 1 case of double gene abnormality was found, and 1 case of single gene abnormality was found in group 1-score; in group 2-score, 5 cases were single gene abnormality and 1 case was three gene abnormality, so the gene abnormality was inconsistent with the protein expression. Conclusions:The incidence of DHL in DLBCL patients in China is low. The major gene abnormalities are c-myc or bcl-2, bcl-6 single gene abnormalities.

Retinopathy of prematurity screening is very important for early identification of retinopathy of prematurity in premature infants, but procedural pain caused by screening process seriously affects the growth and development of premature infants. This paper reviews the non-pharmacological intervention methods for relieving procedural pain of retinopathy of prematurity screening at home and abroad, so as to provide theoretical basis for medical staff to carry out procedural pain management of retinopathy of prematurity screening.

The successful retrieval of ancient mitochondrial DNA (mtDNA) from Neanderthals provides powerful experimental evidence that clarifies the arguments between the out-of-Africa and multiregional models of evolution. However, the lack of nuclear DNA from Neanderthal fossils and mtDNA of early modern human fossils dating back to approximately the same time in the Pleistocene constitutes a limitation that may compromise the significance of mtDNA phylogenetic analysis. In this report, we introduce a mitochromic analysis using Neanderthal mtDNA as a foreign transgene and humans as a naturally occurring transgenic species. Forty Neanderthal mtDNA retrievable nuclear fragments were identified by blasting human genome data with Neanderthal mtDNA. Five of the 40 fragments exhibited higher correlation with Neanderthal mtDNA than those with modern human mtDNA. Furthermore, these five nuclear fragments harbor Neanderthal mtDNA-unique haplotypes. Based on the 98%+ identity between Neanderthal and modern human mtDNA when compared by groups, we suggest that some of the modern human nuclear fragments retrieved using Neanderthal mtDNA may aid in decoding Neanderthal genetic information, and also may simultaneously demonstrate a close genetic evolutionary relationship between modern humans and Neanderthals.

Objective:To explore the feasibility of predicting TP53 mutation risk by immunohistochemical staining (IHC) pattern of P53 in Chinese diffuse large B-cell lymphoma (DLBCL) and its correlation with a prognostic difference.Methods:Between January 2021 and December 2021, 51 DLBCL cases at Beijing Boren Hospital were gathered. These cases had both IHC and next-generation sequencing (NGS) results. IHC classified the P53 protein expression pattern into a loss (<1% ) , diffuse (>80% ) , and heterogeneous (1% -80% ) . The sensitivity and specificity of the predicting TP53 mutation by IHC were assessed by comparing the results of the NGS, and the TP53 high mutation risk group included both loss and diffuse expression of P53. From June 2016 to September 2019, Peking University Cancer Hospital collected 131 DLBCL cases with thorough clinicopathological and follow-up data. From their tumor blocks, tissue microarray blocks were made for IHC evaluation of P53 expression pattern, and prognosis effect of P53 studies.Results:Among 51 cases with both IHC and NGS results, 23 cases were classified as TP53 high mutation risk (7 cases loss and 16 cases diffuse) , 22/23 cases were proved with mutated TP53 by NGS. Only 1 of the 28 cases classified as TP53 low mutation risk was proved with mutated TP53 by NGS. IHC had a sensitivity and specificity of 95.7% and 96.4% for predicting TP53 mutation. NGS identified a total of 26 TP53 mutations with a mutation frequency of 61.57% (13.41% -86.25% ) . In the diffuse group, 16 missense mutations and 2 splice mutations were detected; 6 truncating mutations and 1 splice mutation were detected in the loss group; 1 truncating mutation was detected in the heterogeneous group. Multivariate analysis demonstrated that TP53 cases with high mutation risk have impartial adverse significance for the 131 patients included in survival analysis ( HR=2.612, 95% CI 1.145-5.956, P=0.022) . Conclusion:IHC of P53 exhibiting loss (<1% ) or diffuse (>80% ) pattern indicated TP53 high mutation risk, IHC can predict TP53 mutation with high specificity and sensitivity. TP53 high mutation risk is an independent predictor for adverse survival.

Objective:To explore the clinical application of NanoString fluorescent barcode technology in the molecular subtyping of diffuse large B-cell lymphoma (DLBCL), and to analyze the correlation between the cell-of-origin subtype and prognosis of patients.Methods:The tumor tissue samples of 12 patients with DLBCL at the Third People's Hospital of Datong of Shanxi Province and 8 patients with DLBCL at Peking University, Health Science Center between January 2014 and December 2019 were collected. According to Hans algorithm, all patients were divided into 1 case of germinal center-derived B-cell (GCB) type and 19 cases of non-GCB type. NanoString platform was used to analyze the expression level differences of 15 genes-related to Lymph2Cx molecular subtyping of all samples at mRNA level. Hierarchical clustering was used to subgroup 20 DLBCL cases and to contrast the prognosis in different subgroups according to the subtyping.Results:NanoString fluorescent barcode technology was used to detect samples of 20 DLBCL cases and hierarchical clustering analysis was performed, and then subtyping results showed that 11 cases were GCB-like type and 9 cases were activated B cell (ABC)-like type. Based on Hans algorithm, 10 GCB-like cases were non-GCB type. According to the survival analysis, GCB-like group had a better overall survival compared with that in ABC-like group ( P=0.019). Conclusion:NanoString fluorescent barcode technology can be successfully applied to the cell-of-origin subtyping of DLBCL, and the molecular subtyping strategy can effectively predict the prognosis of patients.

Objective:To study the iodine nutritional status of pregnant women in Jiangxi Province, and to provide basis for iodine supplementation scientifically.Methods:In 2019, 100 counties (cities, districts, referred to as counties) of 11 cities in Jiangxi Province were selected by systematic sampling. Each county was divided into five sections according to five directions: east, west, south, north and middle. One township (street) was taken in each section, and 20 pregnant women (balanced early, middle and late pregnancy) were taken from each township (street) to detect their family salt iodine and urinary iodine levels in order to compare the levels of salt iodine and urinary iodine of different cities and the distribution of urinary iodine in different stages of pregnancy.Results:A total of 10 000 edible salt samples were collected from the families of pregnant women, the median of salt iodine was 24.53 mg/kg, the consumption rate of qualified iodized salt was 97.05% (9 705/10 000), and the iodized salt coverage rate was 99.80% (9 980/10 000). There was no significant difference in the iodine content of edible salt of pregnant women in different cities ( H = 3.42, P > 0.05). A total of 10 000 urine samples were collected from pregnant women, the median of urinary iodine was 175.58 μg/L. There was a statistically significant difference in the urinary iodine content of pregnant women in different cities ( H = 28.80, P < 0.01). There was no statistically significant difference in urinary iodine distribution of pregnant women in different stages of pregnancy (χ 2 = 5.73, P > 0.05). Conclusion:The iodine nutritional status of pregnant women in Jiangxi Province is in a suitable state, but the distribution of iodine nutritional status of pregnant women in different regions is uneven, iodine nutritional status of pregnant women in key regions should be paid attention to.