Objective To analyze acupoint selection law of Professor Fu Wenbin in using acupuncture for the treatment of insomnia based on data mining technology;To provide references for the formulation and optimization of clinical treatment plans.Methods The cases of insomnia treated by acupuncture in the Acupuncture and Moxibustion Department of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 1,2020 to December 31,2021 and in the Acupuncture and Moxibustion Department of Shenzhen Bao'an Hospital of Traditional Chinese Medicine from August 1,2018 to December 31,2021 were collected.A database of prescription information for acupuncture treatment for insomnia was established.The law of acupoint selection frequency,meridians,specific acupoints,correlation analysis and hidden structure analysis for acupuncture treatment of insomnia was mined.Results A total of 517 prescriptions were collected.Acupoints were mainly taken from Baihui(DU20,516 times),Yintang(DU29,499 times),Zhongwan(RN12,482 times)and Taichong(LR3,410 times),and meridians were mainly from Conception Vessel(2 120 times,11 acupoints),Governor Vessel(1 074 times,5 acupoints),liver meridian(410 times,1 acupoint),stomach meridian(401 times,8 acupoints)and kidney meridian(300 times,6 acupoints).The main specific acupoints were the Jiaohui(2 723 times,20 acupoints),Mu(892 times,4 acupoints),and Yuan(746 times,8 acupoints).The core acupoint combination based on Zhongwan-Baihui,Yintang(RN12-DU20-DU29)was formed by the correlation analysis of high-frequency acupoints,and the hidden structure of high-frequency acupoints was analyzed to obtain four comprehensive clustering models corresponding to the evidence of heart-kidney disharmony,liver depression and kidney deficiency,liver depression and kidney deficiency,and heart and gallbladder dysregulation.Conclusion Professor Fu Wenbin uses acupuncture to treat insomnia,with balancing yin and yang,regulating Conception Vessel and Conception Vessel as the basic treatment principle,dredging the liver to regulate the spirit,harmonizing the stomach to calm the spirit,communicating with the heart and kidney,and treating the heart and gallbladder as the treatment method.

Objective To analyze acupoint selection law of Professor Fu Wenbin in using acupuncture for the treatment of insomnia based on data mining technology;To provide references for the formulation and optimization of clinical treatment plans.Methods The cases of insomnia treated by acupuncture in the Acupuncture and Moxibustion Department of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 1,2020 to December 31,2021 and in the Acupuncture and Moxibustion Department of Shenzhen Bao'an Hospital of Traditional Chinese Medicine from August 1,2018 to December 31,2021 were collected.A database of prescription information for acupuncture treatment for insomnia was established.The law of acupoint selection frequency,meridians,specific acupoints,correlation analysis and hidden structure analysis for acupuncture treatment of insomnia was mined.Results A total of 517 prescriptions were collected.Acupoints were mainly taken from Baihui(DU20,516 times),Yintang(DU29,499 times),Zhongwan(RN12,482 times)and Taichong(LR3,410 times),and meridians were mainly from Conception Vessel(2 120 times,11 acupoints),Governor Vessel(1 074 times,5 acupoints),liver meridian(410 times,1 acupoint),stomach meridian(401 times,8 acupoints)and kidney meridian(300 times,6 acupoints).The main specific acupoints were the Jiaohui(2 723 times,20 acupoints),Mu(892 times,4 acupoints),and Yuan(746 times,8 acupoints).The core acupoint combination based on Zhongwan-Baihui,Yintang(RN12-DU20-DU29)was formed by the correlation analysis of high-frequency acupoints,and the hidden structure of high-frequency acupoints was analyzed to obtain four comprehensive clustering models corresponding to the evidence of heart-kidney disharmony,liver depression and kidney deficiency,liver depression and kidney deficiency,and heart and gallbladder dysregulation.Conclusion Professor Fu Wenbin uses acupuncture to treat insomnia,with balancing yin and yang,regulating Conception Vessel and Conception Vessel as the basic treatment principle,dredging the liver to regulate the spirit,harmonizing the stomach to calm the spirit,communicating with the heart and kidney,and treating the heart and gallbladder as the treatment method.

Objective:This study aimed to summarize the clinical characteristics and prognosis of patients with bone marrow invasive follicular lymphoma (FL) and discuss the treatment modalities.Methods:This study included 183 consecutive patients with FL accompanied by bone marrow invasion and receiving regular treatment at the Hospital of Hematology, Chinese Academy of Medical Sciences, from January 2013 to December 2022. Clinical data were retrospectively collected and analyzed, and single and multifactorial analyses of survival prognosis were conducted with the Kaplan-Meier method and Cox regression model.Results:The median age was 48 (range: 19 - 78) years, and the male-to-female ratio was 0.9∶1. All of the patients had bone marrow invasion, 27.8% had increased lactate dehydrogenase levels, 42.1% had lymphocyte counts of >5×10 9/L, 18.4% had abnormal chromosomal karyotypes, and 48.6% had Ki-67 index of ≥30% in lymphoid tissue. Comparison of different subgroups: lymphocyte counts of >5×10 9/L, number of lymph nodes of ≥5 involved, and proportion of bone marrow chromosomal abnormalities occurring were higher in the anthracycline-intensive treatment group than in the rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) protocol and the nucleoside analog (including CD20 monoclonal antibody in combination with fludarabine and bendamustine) groups (all P<0.05). The complete remission rate was 39.1% in the conventional R-CHOP group, which was lower and statistically significant than that in the intensive treatment group (55.1%) and the nucleoside analog group (62.5%) ( P=0.042). The multivariate analysis for survival analysis revealed high risk of FLIPI ( HR= 1.910, 95% CI 1.036 - 3.522, P=0.036), chromosomal abnormalities karyotype ( HR=2.666, 95% CI 1.333-5.331, P=0.006), and conventional R-CHOP treatment ( HR=2.287, 95% CI 1.140-4.591, P=0.020) were the independent adverse prognostic factors affecting progression-free survival (PFS), whereas POD24 was the only independent adverse prognostic factor affecting overall survival (OS) adverse prognostic factor ( HR=9.581, 95% CI 3.000 - 30.593, P<0.001) . Conclusions:The clinical presentations of patients with bone marrow invasive FL were easy to combine the clinical features, including increased lymphocyte count, chromosomal abnormalities, and Ki-67 index in lymphoid tissues. The FLIPI score, chromosomal abnormal karyotype, and high-lymphoid-tissue Ki-67 index were the poor prognostic factors influencing PFS. R-CHOP therapy demonstrated a poor prognosis in this group of patients.

Objective:To explore the efficacy and safety of ibrutinib for the treatment of newly treated and relapsed refractory (R/R) lymphoplasmacytic lymphoma (LPL) /Waldenstr?m macroglobulinemia (WM) .Methods:Retrospectively collected clinical data of 98 cases of newly treated and R/R LPL/WM patients who received ibrutinib treatment at the Hematology & Blood Diseases Hospital of the Chinese Academy of Medical Sciences from March 2016 to June 2023, and analyzed their efficacy and safety.Results:A total of 98 LPL/WM patients were included, which consisted of 45 newly treated patients and 53 R/R patients. Of these, 74 were males (75.5%) and the cohort had a median age of 64 (42-87) years. Eighty-eight patients were eligible for efficacy evaluation with a median treatment time of 20.8 (2.1-55.0) months, a major remission rate (MRR) of 78.4%, and an overall response rate (ORR) of 85.2%. The MRR and ORR of the newly treated patients were 78.4% and 86.5%, respectively, whereas the MRR and ORR of the R/R patients were 78.4% and 84.3%, respectively. There were no statistically significant differences in MRR and ORR between the initial treatment and R/R patients (all P values >0.05) . The median follow-up period was 29.1 (2.9-50.3) months and the median overall survival time for newly treated and R/R patients was not reached. The median progression-free survival time was 23.5 (95% CI 10.5-36.5) months and 45.0 (95% CI 34.0-56.0) months, respectively, with no statistically significant differences (all P values >0.05) . There were 25 deceased patients and no deaths were related to ibrutinib treatment. The main adverse reactions of ibrutinib were thrombocytopenia (5.1%) , pneumonia (8.1%) , and hyperuricemia (21.4%) . The incidence of atrial fibrillation was 2.0%. Conclusion:Ibrutinib exhibits good efficacy and safety for newly treated and R/R LPL/WM patients.

Objective To evaluate the application of immediate resection after interventional embolization in treating hypervascular nasal skull base tumors.Methods The clinical data of 25 patients with hypervascular nasal skull base tumors,who were treated at the Affiliated Eye ENT Hospital of Fudan University of China from December 2020 to June 2022,were retrospectively analyzed.All patients underwent tumor surgical resection immediately after interventional embolization on the same day of admission.The success rate of embolization,incidence of complications,amount of blood loss during resection,tumor resection condition and prognosis were analyzed.Results Successful immediate surgical resection after interventional embolization was accomplished in all the 25 patients.Arterial approach was used for the interventional embolization,which was successfully performed under general anesthesia(n=19)or local anesthesia(n=6).No embolization-related complications occurred.The tumor resection was successfully accomplished under nasal endoscopy,endoscopy-guided translabial-gingival crevicular incision,or under oral endoscopy.No resection-related complications occurred.The median amount of blood loss during resection was 844 mL(range of 100-2 000 mL).Conclusion For the treatment of hypervascular nasal skull base tumors,immediate surgical resection after interventional embolization is clinically safe and feasible,and this therapeutic method is worthy of clinical promotion.

Objective:This study aimed to summarize the clinical characteristics and prognosis of patients with bone marrow invasive follicular lymphoma (FL) and discuss the treatment modalities.Methods:This study included 183 consecutive patients with FL accompanied by bone marrow invasion and receiving regular treatment at the Hospital of Hematology, Chinese Academy of Medical Sciences, from January 2013 to December 2022. Clinical data were retrospectively collected and analyzed, and single and multifactorial analyses of survival prognosis were conducted with the Kaplan-Meier method and Cox regression model.Results:The median age was 48 (range: 19 - 78) years, and the male-to-female ratio was 0.9∶1. All of the patients had bone marrow invasion, 27.8% had increased lactate dehydrogenase levels, 42.1% had lymphocyte counts of >5×10 9/L, 18.4% had abnormal chromosomal karyotypes, and 48.6% had Ki-67 index of ≥30% in lymphoid tissue. Comparison of different subgroups: lymphocyte counts of >5×10 9/L, number of lymph nodes of ≥5 involved, and proportion of bone marrow chromosomal abnormalities occurring were higher in the anthracycline-intensive treatment group than in the rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) protocol and the nucleoside analog (including CD20 monoclonal antibody in combination with fludarabine and bendamustine) groups (all P<0.05). The complete remission rate was 39.1% in the conventional R-CHOP group, which was lower and statistically significant than that in the intensive treatment group (55.1%) and the nucleoside analog group (62.5%) ( P=0.042). The multivariate analysis for survival analysis revealed high risk of FLIPI ( HR= 1.910, 95% CI 1.036 - 3.522, P=0.036), chromosomal abnormalities karyotype ( HR=2.666, 95% CI 1.333-5.331, P=0.006), and conventional R-CHOP treatment ( HR=2.287, 95% CI 1.140-4.591, P=0.020) were the independent adverse prognostic factors affecting progression-free survival (PFS), whereas POD24 was the only independent adverse prognostic factor affecting overall survival (OS) adverse prognostic factor ( HR=9.581, 95% CI 3.000 - 30.593, P<0.001) . Conclusions:The clinical presentations of patients with bone marrow invasive FL were easy to combine the clinical features, including increased lymphocyte count, chromosomal abnormalities, and Ki-67 index in lymphoid tissues. The FLIPI score, chromosomal abnormal karyotype, and high-lymphoid-tissue Ki-67 index were the poor prognostic factors influencing PFS. R-CHOP therapy demonstrated a poor prognosis in this group of patients.

Objective:This retrospective, single-center study aimed to evaluate the efficacy and safety of programmed death-1 (PD-1) inhibitors, either as monotherapy or in combination with chemotherapy, in the management of relapse/refractory classical Hodgkin's lymphoma (R/R cHL) .Methods:A total of 35 patients with R/R cHL who received treatment at the Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College from September 2016 to December 2020 were enrolled in this study. Among them, 17 patients received PD-1 inhibitor monotherapy (PD-1 inhibitor group), while 18 patients received a combination of PD-1 inhibitor and chemotherapy (PD-1 inhibitor + chemotherapy group). Clinical data and follow-up information were retrospectively analyzed, and survival analysis was conducted using the Kaplan-Meier method and Cox proportional hazards model.Results:The median age of the 35 patients with R/R cHL was 29 years (range: 11-61 years), with 54.3% being male. According to the Ann Arbor staging system, 62.9% of patients presented with advanced (stage Ⅲ/Ⅳ) disease, and 48.6% had extranodal involvement. Before PD-1 inhibitor therapy, the median number of prior lines of therapy was 2 (range: 1-3). Objective responses were observed in 28 patients, including 22 complete response (CR) cases, resulting in an overall response rate (ORR) of 80.0% and a CR rate of 62.9%. Specifically, the ORR and CR rates were 64.7% and 58.8%, respectively, in the PD-1 inhibitor group and 94.4% and 66.7%, respectively, in the PD-1 inhibitor + chemotherapy group. Among the 18 patients who underwent sequential autologous hematopoietic stem cell transplantation (auto-HSCT) [13 CR and five partial response (PR) cases], eight patients received PD-1 inhibitor therapy after auto-HSCT as consolidation therapy. All patients maintained a CR status after transplantation, and they exhibited significantly improved progression-free survival (PFS) rates compared with those who did not undergo sequential auto-HSCT (4-year PFS rates: 100% vs 53.5% ; P=0.041). The incidence of immune-related adverse events was 29%, with only one patient experiencing grade≥3 adverse reactions, which indicated a favorable safety profile for the treatment approach. Conclusions:PD-1 inhibitor monotherapy demonstrates notable efficacy and sustained response in patients with R/R cHL. PD-1 inhibitors combined with chemotherapy significantly improve response rates. Additionally, for salvage therapy-sensitive patients, consolidation treatment with PD-1 inhibitors after auto-HSCT exhibits the potential for prolonging PFS.

Humans ; Prognosis ; Multiple Myeloma/diagnosis* ; Neoplasm Staging ; Hematopoietic Stem Cell Transplantation ; Patients ; Retrospective Studies

Objective:To study the clinical, histopathological, and genetic features of large B-cell lymphoma (LBCL) with IRF4 rearrangement.Methods:Six patients presenting at our center between December 2017 and October 2021 were evaluated by pathological examination, fluorescence in situ hybridization, and next-generation sequencing. The relevant literature was reviewed.Results:①The study sample included three males and three females with a median age of 33 years. Three tumors were in the tonsils, two in the lymphoid nodes, and one in the dorsal lump. All patients were treated using the RCDOP (rituximab, cyclophosphamide, liposomal doxorubicin, vincristine, prednisone) regimen. All of them were alive at the time of follow-up in November 2021. ②Microscopic examination showed an entirely follicular pattern in one case and an entirely diffused pattern in 5 cases. The tumor cells were medium to large, and most of the lesions were dilatative with brisk mitotic activity ( n=five cases) and no starry sky pattern ( n=6 cases) . ③Four cases exhibited a GCB phenotype, and the other two exhibited a non-GCB phenotype. All of the cases were positive for CD20, PAX-5, MUM, and BCL6, and negative for CD5. Moreover, CD10, BCL2, and c-MYC were positive in 4, 3, and 2 cases, respectively.④IRF4 gene rearrangement was identified in all cases, BCL6 gene rearrangement was detected in 5 cases, and 2 cases were positive. BCL2 and MYC gene rearrangement were performed in 5 cases, all negative. ⑤Three paraffin tissue samples were used for next-generation sequencing, and lymphoma-related gene mutations such as IRF4, TP53, IGLL5, and MYD88 were detected in 3 cases. Conclusions:LBCL with IRF4 rearrangement is a rare entity with unique clinical, pathological, and genetic characteristics. This entity’s pathogenesis, treatment options, and long-term prognosis still need to be explored further.

Objective:The study aims to explore the clinical and biological characteristics of patients with non-IgM lymphoplasmacytic lymphoma (LPL) .Methods:The clinical data of 340 patients with LPL admitted to the Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College were collected retrospectively, including 23 cases of the non-IgM LPL and 317 cases of the Waldenstr?m's macroglobulinemia (WM) , from July 1993 to August 2020. The clinical and biological characteristics of the two groups were compared.Results:Among 23 patients with the non-IgM type LPL, two patients secreted monoclonal IgA, 14 patients secreted monoclonal IgG, and seven patients did not secrete monoclonal immunoglobulin. The median age of the non-IgM LPL and WM were both 62 (35-81) years old. Compared with the WM group, the proportion of women (56.5% vs 27.3%, P=0.007) , the proportion of splenomegaly (60.1% vs 43.8%, P=0.100) , and the proportion of extranodal invasion (21.7% vs 12.3%, P=0.672) in non-IgM LPL group were higher. Eighteen patients were tested for MYD88 gene mutation, and the overall mutation rate of MYD88 was 55.6%. In the non-IgM LPL group, a total of 17 patients received treatment, which had a comparable proportion (94.4% vs 92.7%, P=0.488) to the WM group. Sixteen patients were evaluated for efficacy, and the overall remission rate of the first-line treatment was 87.5%. The median follow-up time was 33.9 (3.5-125.1) months, and the median PFS and OS were both not reached. The 3-year PFS and OS rates were 71.4% and 68.9%, respectively. In the WM group, the median PFS was 66.2 months and the median OS was 78.1 months. Compared with the WM group, in the non-IgM group no significant differences in PFS ( P=0.340) and OS ( P=0.544) were seen. Conclusion:The clinical and biological characteristics of the non-IgM LPL and WM patients were similar. However, the proportion of women and extranodal involvement were higher in the non-IgM LPL group. The survival and prognosis of the non-IgM LPL patients were similar to those of the WM patients.