Objective:To analyze the clinical features and prognosis of patients with lymphoplasmacytic lymphoma/Waldenstr?m macroglobulinemia (LPL/WM) transformed into diffuse large B-cell lymphoma (DLBCL) .Methods:This study retrospectively analyzed the clinical data of five patients with LPL/WM transformed to DLBCL diagnosed and treated at a multicenter hospital in Hunan Province from December 2020 to April 2023. Clinical manifestations, treatment regimens, and therapeutic efficacy before and after the transformation were compared.Results:Of the five patients, four were male and one was female, with a median age of 64.0 (57.0–80.0) years, all of whom had abnormally increased β 2-microglobulin levels at diagnosis, and two were combined with increased lactate dehydrogenase levels. The MYD88 L265P mutation was detected in 4 patients, whereas 1 carried the FAT1 and NOTCH1 mutations, and none demonstrated CXCR4 mutations. Three patients were negative for the TP53 mutation, and two were not tested. Before transformation, three patients were treated with Bruton tyrosine kinase inhibitor therapy, and one patient was treated with the bendamustine plus rituximab regimen. All patients eventually transformed into non-growth center-derived DLBCL, with a median time to conversion of 11.8 (4.0–19.0) months, and most of them presented with weight loss, lymph node enlargement, splenomegaly, and extranodal involvement. Posttransformation, the patients were mainly treated with the rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (R-CHOP) regimen, with an optimal outcome of partial remission. Disease progression occurred in 4 of the patients, with a median overall survival of 16.8 (10.0–26.0) months. Conclusion:Transformation from LPL/WM to DLBCL is rare. Patients should remain highly vigilant for transformation if they develop rapidly enlarging lymph nodes and/or newly involved lymph nodes, worsening systemic symptoms, and declining body mass. R-CHOP regimen may induce a partial response in some cases; however, the overall prognosis remains poor.

Objective:To analyze the clinical features and prognosis of patients with lymphoplasmacytic lymphoma/Waldenstr?m macroglobulinemia (LPL/WM) transformed into diffuse large B-cell lymphoma (DLBCL) .Methods:This study retrospectively analyzed the clinical data of five patients with LPL/WM transformed to DLBCL diagnosed and treated at a multicenter hospital in Hunan Province from December 2020 to April 2023. Clinical manifestations, treatment regimens, and therapeutic efficacy before and after the transformation were compared.Results:Of the five patients, four were male and one was female, with a median age of 64.0 (57.0–80.0) years, all of whom had abnormally increased β 2-microglobulin levels at diagnosis, and two were combined with increased lactate dehydrogenase levels. The MYD88 L265P mutation was detected in 4 patients, whereas 1 carried the FAT1 and NOTCH1 mutations, and none demonstrated CXCR4 mutations. Three patients were negative for the TP53 mutation, and two were not tested. Before transformation, three patients were treated with Bruton tyrosine kinase inhibitor therapy, and one patient was treated with the bendamustine plus rituximab regimen. All patients eventually transformed into non-growth center-derived DLBCL, with a median time to conversion of 11.8 (4.0–19.0) months, and most of them presented with weight loss, lymph node enlargement, splenomegaly, and extranodal involvement. Posttransformation, the patients were mainly treated with the rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (R-CHOP) regimen, with an optimal outcome of partial remission. Disease progression occurred in 4 of the patients, with a median overall survival of 16.8 (10.0–26.0) months. Conclusion:Transformation from LPL/WM to DLBCL is rare. Patients should remain highly vigilant for transformation if they develop rapidly enlarging lymph nodes and/or newly involved lymph nodes, worsening systemic symptoms, and declining body mass. R-CHOP regimen may induce a partial response in some cases; however, the overall prognosis remains poor.

OBJECTIVES: To summarize our experience with the sural neurofasciocutaneous flap for reconstructing the soft tissue defects over the forefoot distal to the connecting line of midpoints in the metatarsal bones, and to compare the outcomes between the flap for resurfacing the defects distal and proximal to the connecting line. METHODS: The clinical data of 425 sural neurofasciocutaneous flaps for repairing the soft tissue defects in the middle and lower leg, ankle, and foot between Apr. 2002 and Apr. 2020 were reviewed. Based on the connecting line of midpoints of the metatarsals, the sural neurofasciocutaneous flaps were divided into a forefoot group (flaps with furthest edges distal to the connecting line) and a peri-ankle group (flaps with the furthest edges proximal to the connecting line). RESULTS: The partial necrosis rate in the forefoot group (14.5%, 10/69) was significantly higher than that in the peri-ankle group (7.0%, 25/356), with significant difference (P<0.05). Using the flap alone or in combination with a simple salvage treatment, the ratio of successful coverages of the defects was 98.6% (68/69) in the forefoot group, and 97.8% (348/356) in the peri-ankle group, respectively, with no statistical difference (P>0.05). CONCLUSIONS The sural neurofasciocutaneous flap is a better choice for covering the soft tissue defects over the forefoot distal to the connecting line of midpoints of the metatarsal bones. The survival reliability of the sural neurofasciocutaneous flap reconstructing the soft tissue defect proximal to the connecting line is superior to that of the flap reconstructing the defect distal to the connecting line.
Ankle/surgery* ; Humans ; Reconstructive Surgical Procedures ; Reproducibility of Results ; Soft Tissue Injuries/surgery* ; Surgical Flaps

Objective To understand the distribution of the blood donors with positive blood test results in Wuzhou .Methods The detection results of ALT ,HBsAg ,anti‐HCV ,anti‐HIV and anti‐TP of 108 879 cases of blood donors were retrospectively ana‐lyzed in 2010 -2012 .Results In the 108 879 cases of blood donors ,the total positive rate of 5 indicators was 6 .01% (6 548/108 879) .The positive rates of ALT ,HBsAg ,anti‐HCV ,anti‐HIV and anti‐TP were 4 .86% ,0 .57% ,0 .20% ,0 .07% and 0 .59% , respectively .The positive rates of ALT ,HBsAg and anti‐HCV were significantly different between males and females (P<0 .05) . The blood donors in 18-30 age group had the highest positive rates of ALT and anti‐TP ,and the blood donors in >30 -40 age group had the highest anti‐HCV positive rate .Conclusion Enhancing the blood donation propaganda ,doing a good job in the blood before consulting ,and choosing low risk blood donors are important to guarantee of the blood quality and reduction of blood transfu‐sion transmitted diseases .

Objective To explore the lowest and most effective dose of dezocine in preventing postoperative pain after painless artificial abortion.Methods A total of 180 ASA Ⅰ ～ Ⅱ patients who accepted painless artificial abortion were randomly divided into 6 groups (n =30 patients per group).Group 1 (control) was given the placebo (0.9％ NS; 2 ml) by vein while other groups were given dezocine by vein with 0.01 mg/kg (group 2),0.02 mg/kg (group 3),0.03 mg/kg (group 4),0.04 mg/kg (group 5),and 0.05 mg/kg (group 6),respectively.The dosage of propofol,BP,HR,SpO2 during the operation,operation time,consciousness recovery time,analgesic effect (VAS score),leaving time,defecation feeling,and untoward reaction of each group were recorded and compared.Results The dosage of propofol in the 5 dezocine groups were significantly lower than that in the control group,respectively (t =2.38,4.72,6.03,4.57,3.96,P ＜ 0.05),while the difference in the operation time,consciousness recovery time and leaving time between the 5 dezocine groups and the control group had not statistical significance (P ＞0.05).The effect of postoperative analgesia and defecation feeling were apparently improved in the group 3,4,5 and 6,compared to the control group(group 3:x2 =3.36,6.94,P ＜ 0.05;group 4:x2 =7.17,15.01,P ＜ 0.05 ; group 5:x2 =15.5,24.3,P ＜ 0.01 ; group 6:x2 =13.01,20.24,P ＜ 0.01).Conclusions The lowest and most effective dose of dezocine was 0.05 mg/kg in preventing postoperative pain after painless artificial abortion.

This study sought to evaluate the effect of steep pulsed electric fields (SPEFs) on the immune response of Wistar mice inoculated with Walker256 sarcoma. Thirty mice were randomly divided into three groups: control group (group A, inoculated with Walker256 sarcoma, not treated), treatment group (group B, inoculated with Walker256 sarcoma, treated by SPEFs), and normal control group (group C, inoculated with normal saline, not treated). Tumor size was measured before and every 3 days after treatment by vernier caliper. MTT methods were used to assess the lymphocytes proliferation and the natural killer (NK) cells activity. TNF-a activity was measured by ELISA. Statistical analysis was performed utilizing the SPSS10.0 software package. The experiment results revealed that tumor growth was significantly inhibited in group B as compared with group A (P < 0.01), and that lymphocytes proliferation, NK cells activity and TNF-a activity in group B were not significantly different from those in group C (P = 0.953, P = 0.130, P = 0.080, respectively) but markedly higher than those in group A (P < 0.05). The results also showed that SPEFs could not only kill tumor cells but also induce antitumor immune response and improve the immune function of the host efficiently.
Animals ; Carcinoma 256, Walker ; immunology ; pathology ; therapy ; Electromagnetic Fields ; Female ; Killer Cells, Natural ; immunology ; Leukocytes ; immunology ; Lymphocyte Activation ; Male ; Mice ; Neoplasm Transplantation ; Pulse ; Random Allocation ; Spleen ; cytology ; Tumor Necrosis Factor-alpha ; biosynthesis

Objective To assess the effect of the gamma knife radiosurgery (GKS) for acoustic neuromas, and to analyze the MRI features of the tumors after GKS. Methods GKS was performed in 309 patients with acoustic neuromas from December 1994 to December 2002 at our center. The Leksell Gamma Knife models B and C were used. 249 cases with 256 tumors were followed up with MRI, which included 107 males and 142 females. The median age of the patients was 48.7?14.2 years (10-77 years). GKS was applied as primary treatment for 189 cases (75.9%), and was an adjunctive management approach for 60 cases (24.1%). The median clinical follow-up period and radiological follow-up period was (26.4?21.3) months (6-101 months) and (22.4?19.0) months (6-93 months), respectively. Results Of the 256 tumors, 79 tumors (30.8%) regressed, 165 tumors (64.5%) remained stable, 12 tumors (4.7%) enlarged, and the overall tumor control rate was 95.3%. Among 30 tumors of NF-Ⅱ , 8 tumors (26.6%) regressed, 19 tumors (63.4) remained stable, and 3 tumors (10.0%) enlarged, and tumor control rate was 90%. The rate of hearing deterioration was 22.7%, the rate of permanent facial paralysis was 0%, the rate of transient facial paralysis was 5.9%, and the incidence of transient trigeminal neuropathies was 19.9%. On the image of follow-up MRI, 79 tumors (30.0%) showed loss of contrast enhancement (LOE). LOE was the imaging property of neuromas on follow-up MRI, which symbolized a chronic decrease in the vascularity of neuromas. The histological findings of LOE demonstrated radiation-induced tumor necrosis. The transient swelling of tumors could not be confounded with the growth of tumors. Conclusion GKS is confirmed to be an effective treatment for acoustic neuromas and plays an important role in the control of NF―Ⅱ, and GKS can prevent cranial nerve from injury to a great extent.