Mantle cell lymphoma(MCL)is a rare B-cell non-Hodgkin's lymphoma characterized by clini-cal and pathological features encompassing both indolent and aggressive subtypes.Significant progress has been made in the past decade regarding the development of novel therapeutic options for MCL.Particularly,Bruton's tyrosine kinase inhibitor(BTKi)has exhibited remarkable efficacy in treating patients with MCL by specifically targeting the BTK protein,thereby inhibiting B-cell proliferation and inducing potent anti-tumor effects.Currently,global approval has been granted to five BTK inhibitors for MCL treatment,including the first-generation Ibrutinib,second-generation Acalabrutinib,Zanubrutinib,Orelabrutinib,as well as the non-covalent BTKi Pirtobrutinib.This review provides a comprehensive summary of findings from clinical trials investigating the use of BTKi in MCL treatment and offers valuable insights for clinical practice.

Objective To study the distribution and drug resistance characteristics of pathogenic bacteria in the elderly population of China by collecting and analyzing the standardized case data on the pathogens of infections in elderly patients,and to facilitate the establishment of a standardized layered surveillance system for pathogenic bacteria in China.Methods We collected the case data of elderly patients(≥65 years old)from 62 sentinel hospitals across the country in 2021.Then,we statistically analyzed the data by patient age,their geographical region,the distribution of pathogenic bacteria,and the drug resistance characteristics of main pathogens.Results A total of 3468 cases from across the country were included in the study.The top three sources of patients were the intensive care unit(13.2%),the department of respiratory medicine(11.2%),and the department of general surgery(8.4%).The top three types of specimens were urine(25.5%),sputum(20.6%),and blood(18.7%).A total of 3468 strains of pathogens were isolated,among which,78.9%were gram-negative bacteria and 21.1%were gram-positive bacteria.The top five types of bacteria were Escherichia coli(20.9%),Klebsiella pneumoniae(18.3%),Pseudomonas aeruginosa(11.2%),Staphylococcus aureus(9.0%),and Acinetobacter baumannii(7.0%).The isolation rates of common important drug-resistant bacteria were 38.0%for methicillin-resistant Staphylococcus aureus(MRSA),68.7%for carbapenem-resistant Acinetobacter baumannii(CRAB),and 38.2%for carbapenem-resistant Pseudomonas aeruginosa(CRPA),20.1%for carbapenem-resistant Klebsiella pneumoniae(CRKP),5.2%for carbapenem-resistant Escherichia coli(CRECO),and 2.1%for vancomycin-resistant Enterococcus(VRE).There were differences in the isolation rates of CRAB and CRKP in clinical care in the elderly population in seven geographical regions of China(P＜0.05).Klebsiella pneumoniae is the most important pathogen in the elderly population≥85 years old,and the isolation rates of CRKP showed significant differences in different age groups(P＜0.05).Conclusion There are significant differences in the drug resistance of pathogenic bacteria in the elderly populations of different regions and age groups in China.Therefore,monitoring the distribution and drug resistance of pathogenic bacteria in the elderly population and formulating targeted treatment plans according to the characteristics of the specific regions and age groups are of great significance to the improvement in the treatment outcomes and prognosis of the elderly population.

Objective Todeterminetherelationshipbetweenthetumorvolumeoftheperipherallungadenocarcinomawith maximum diameter≤3cmandlymphnodemetastasis(LNM).Methods TheMSCTmanifestationsof235subjectswhowerediagnosedasperipheral lungadenocarcinomawithmaximumdiameter≤3cm wereretrospectivelyanalyzed.Thesepatientsweregroupedaccordingtodifferent parametersincludingsmokinghistory,differentiation,tumorconsistencyandavailabilityoftumornecrosis.Tumorvolumeandratesof LNMamongthesegroupswerecompared.ROCanalysiswasusedtocalculatethecut-offvalueanddiagnosticaccuracy.Results (1) ThetumorvolumeofLNMgroupwaslargerthanthatofnoLNMgroup,cut-offvaluewas5.5cm3,andAUCwas0.76;(2)Therates ofLNMofthewell,moderate-well,moderate,moderate-poorandpoordifferentiationgroupswere0%,8.7%,17.7%,45.6%and46.7%respectively.Theratesofpuregroundglassopacity(p-GGO),mixedandsolidtumorwere0%,8.3%and29.3%respectively.The ratesofthetumorpresentandabsentofnecrosiswere47.8%,22.0%respectively(P＜0.05).Conclusion Usingthevolumeoftumor on MSCTtopredictLNMisanewnon-invasivewayofassessingLNM,withhighsensitivityandspecificity,whichcouldsupplymore imaginginformationforsurgeonstochoosethewayoflymphnodedissection.