Objective:To improve the understanding of patients with diffuse large B-cell lymphoma (DLBCL) with pulmonary cryptococcosis.Methods:The clinical data of 1 DLBCL patient with pulmonary cryptococcosis in the Central Hospital of Fengxian District of Shanghai in May 2023 were retrospectively analyzed, and the relevant literatures were reviewed.Results:This 75-year-old female patient was asymptomatic after 2 cycles of R-CHOP chemotherapy. The high-resolution CT of lung showed that lung nodules were progressively enlarged. Antibacterial treatment was ineffective. Pulmonary cryptococcosis was confirmed by bronchoalveolar lavage fluid (BALF) targeted high-throughput sequencing (tNGS) and cryptococcus capsular antigen (CrAg) detection. The central nervous system was not involved. And the long-term adequate-dose fluconazole was prescribed for 6 months, and the treatment against lymphoma was given synchronously. The lung nodule lesions reduced after antifungal therapy for 1 month. The lung nodules disappeared after the follow-up of 6 months after completion of final chemotherapy. The evaluation of lymphoma indicated complete remission.Conclusions:Pulmonary cryptococcosis occurs insidiously and shows no specific symptoms; its imaging manifestations are variable and routine anti-infection is ineffective. Immunochemotherapy for lymphoma patients is a high-risk factor for cryptococcal infection. tNGS and CrAg testing for BALF are effective methods of the confirmed diagnosis. The early and long-term adequate-dose antifungal treatment is the key to preventing the recurrence or progression.

A 61-year-old male patient was simultaneously diagnosed with lung adenocarcinoma and inflammatory myofibroblastic tumor (IMT). The lung adenocarcinoma and IMT harbored two distinct types of ALK translocation, LOC101927285-ALK, and TPM3-ALK, respectively. The ALK Ventana showed strong positivity on both lesions. The patient was therefore given an endobronchial cryotherapy and ALK inhibitor crizotinib. The tumors showed durable response however the left lung adenocarcinoma relapsed at 17th month post-crizotinib treatment. Tissue re-biopsy on the resistant tumor revealed an ALK exon 23 C1156Y missense mutation in addition to LOC101927285-ALK mutation. Further RNA-based sequence uncovered that the noncoding region rearrangement is the fusion mutation of EML4-ALK. The patient was therefore received alectinib, and the tumor exhibited partly response. Overall, it is very rare that two types of pulmonary tumors exist in one patient driven by two distinct ALK fusions, which emphasizes the necessity of gene sequencing in clinical decision-making and individualized therapy.

A 61-year-old male patient was simultaneously diagnosed with lung adenocarcinoma and inflammatory myofibroblastic tumor (IMT). The lung adenocarcinoma and IMT harbored two distinct types of ALK translocation, LOC101927285-ALK, and TPM3-ALK, respectively. The ALK Ventana showed strong positivity on both lesions. The patient was therefore given an endobronchial cryotherapy and ALK inhibitor crizotinib. The tumors showed durable response however the left lung adenocarcinoma relapsed at 17th month post-crizotinib treatment. Tissue re-biopsy on the resistant tumor revealed an ALK exon 23 C1156Y missense mutation in addition to LOC101927285-ALK mutation. Further RNA-based sequence uncovered that the noncoding region rearrangement is the fusion mutation of EML4-ALK. The patient was therefore received alectinib, and the tumor exhibited partly response. Overall, it is very rare that two types of pulmonary tumors exist in one patient driven by two distinct ALK fusions, which emphasizes the necessity of gene sequencing in clinical decision-making and individualized therapy.

Objective To assess the prevalence of dyslipidemia among children and adolescents aged 6-18 years in Yinchuan.Methods A stratified,random cluster sampling was used to select a target samples (1 939 cases) of children from elementary schools,middle schools and high schools in different age groups,with medium economic status.The levels of serum total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),and triglycerides (TG) were measured.Results The prevalence of total dyslipidemia was 15.5 ％ (300/1 939 cases).The prevalence of high TG,high TC,high LDL-C,low HDL-C,high non-HDL-C and hyperlipemia were 5.8％ (113/1 939 cases),0.8％ (18/1 939 cases),1.1％ (21/1 939 cases),10.6％ (205/1 939 cases),0.9％ (18/1 939 cases) and 6.4％ (124/1 939 cases),respectively.Boys were more likely to have dyslipidemia than girls (17.7％ vs.13.3％) and a low HDL-C level (13.1％ vs.8.2％),and the differences between 2 groups were statistically significant (x2 =7.178,P =0.007;x2 =12.337,P ＜ 0.001).Individuals aged 16-18 years had the highest prevalence of total dyslipidemia [19.1％ (89/466 cases)] than other age groups,and the difference was statistically significant(x2 =11.393,P ＜ 0.01).Prevalence of dyslipidemia among the obese,the overweight and the normal weight individuals were 39.7％ (69/174 cases),20.8％ (60/289 cases) and 11.6％ (171/1 469 cases),respectively.Moreover,prevalence of dyslipidemia increased significantly with gravity of obesity,and the difference was statistically significant(x2 =100.180,P ＜ 0.01).Individuals with abdominal obesity had higher prevalence rates of dyslipidemia than that of the non-abdominal obese individuals [31.5％ (92/292 cases) vs.12.6％ (207/1 064 cases)],and the difference was statistically significant (x2 =67.578,P ＜ 0.01).Approximately 39.7％ (69/174 cases) and 31.5 ％ (92/292 cases) obese individuals and abdominal obesity were candidates for taking intervention measures including nutritional counseling,school-based lifestyle as well as community fitness programs.Conclusions Screening and prevention should be regarded for dyslipidemia among children and adolescents,especially for boys and teenagers in Yinchuan.