Objective:To explore the prospects of ovarian tissue oocyte- in vitro maturation (OTO-IVM) in fertility preservation for patients with malignancy. Methods:OTO-IVM outcomes from 27 malignant tumor patients who underwent fertility preservation in Reproductive Medicine Research Center of the Sixth Affiliated Hospital of Sun Yat-Sen University from March 2017 to August 2022 were analyzed, including the number of mature oocytes (M II oocytes), maturation rate, and maturation time. The fertilization rate, the cleavage rate, and the embryonic development potential of IVM-derived M II were also analyzed. Further, the short-term use of gonadotropin (Gn) in OTO-IVM before ovarian tissue acquisition was initially explored. Results:After OTO-IVM, 81.48% (22/27) of patients had at least one M II oocyte, with a mean number of M II oocytes of 3.00 (1.50, 7.00) and a maturation rate of 38.81%. About 4.85% (13/268) of oocytes matured within 24 h; 14.93% (40/268) matured between 24 h and 36 h; 16.79% (45/268) matured between 36 h and 48 h, and only 2.24% (6/268) matured after 48 h. A total of 41 M II oocytes from 4 patients were fertilized by intracytoplasmic sperm injection (ICSI), with a fertilization rate of 85.37% (35/41), cleavage rate of 94.29% (33/35), variable embryo rate of 54.29% (19/35), and high-quality embryo rate of 34.29% (12/35). The IVM rate was significantly higher in patients who used Gn than in those who did not [63.16% (48/76) vs. 29.17% (56/192), P<0.001]. Conclusion:OTO-IVM can be used as a complementary method for fertility preservation in oncology patients and obtain a certain number of oocytes and embryos. Short-term use of Gn before ovarian tissue acquisition can improve oocyte maturation rate, but further studies are needed to verify the value of Gn in OTO-IVM.

Objective:To explore the prospects of ovarian tissue oocyte- in vitro maturation (OTO-IVM) in fertility preservation for patients with malignancy. Methods:OTO-IVM outcomes from 27 malignant tumor patients who underwent fertility preservation in Reproductive Medicine Research Center of the Sixth Affiliated Hospital of Sun Yat-Sen University from March 2017 to August 2022 were analyzed, including the number of mature oocytes (M II oocytes), maturation rate, and maturation time. The fertilization rate, the cleavage rate, and the embryonic development potential of IVM-derived M II were also analyzed. Further, the short-term use of gonadotropin (Gn) in OTO-IVM before ovarian tissue acquisition was initially explored. Results:After OTO-IVM, 81.48% (22/27) of patients had at least one M II oocyte, with a mean number of M II oocytes of 3.00 (1.50, 7.00) and a maturation rate of 38.81%. About 4.85% (13/268) of oocytes matured within 24 h; 14.93% (40/268) matured between 24 h and 36 h; 16.79% (45/268) matured between 36 h and 48 h, and only 2.24% (6/268) matured after 48 h. A total of 41 M II oocytes from 4 patients were fertilized by intracytoplasmic sperm injection (ICSI), with a fertilization rate of 85.37% (35/41), cleavage rate of 94.29% (33/35), variable embryo rate of 54.29% (19/35), and high-quality embryo rate of 34.29% (12/35). The IVM rate was significantly higher in patients who used Gn than in those who did not [63.16% (48/76) vs. 29.17% (56/192), P<0.001]. Conclusion:OTO-IVM can be used as a complementary method for fertility preservation in oncology patients and obtain a certain number of oocytes and embryos. Short-term use of Gn before ovarian tissue acquisition can improve oocyte maturation rate, but further studies are needed to verify the value of Gn in OTO-IVM.

Objective:To investigate the prognosis and its influencing factors of elderly patients with diffuse large B-cell lymphoma (DLBCL), and to provide references for clinical treatment.Methods:The clinical data of 152 patients with DLBCL aged over 60 years old from January 2013 to June 2017 in Shanxi Provincial Cancer Hospital were retrospectively analyzed. Kaplan-Meier method was used for survival analysis, and the log-rank test was used for univariate analysis of factors affecting the prognosis of patients, and the Cox proportional hazard regression model was used for multivariate analysis.Results:The median overall survival (OS) time of 152 elderly patients with DLBCL was 36 months (32-40 months), and the 1, 2, and 3-year OS rates were 80.26%, 61.84%, and 57.24%, respectively. Univariate analysis showed that the differences in the 3-year OS rates of elderly DLBCL patients with different gender, clinical staging, lactate dehydrogenase (LDH), Ki-67, β 2-microglobulin (β 2-MG) levels, smoke history, use of rituximab and CHOP regimens were statistically significant (all P < 0.1). The results of multivariate Cox regression analysis showed that male, late clinical staging, elevated LDH, and elevated β 2-MG were risk factors for the OS of elderly DLBCL patients (all P < 0.05). The use of rituximab and CHOP regimens were the protective factors for the OS of elderly patients with DLBCL (all P < 0.05). Conclusions:The elderly male DLBCL patients with late clinical staging, elevated LDH and elevated β 2-MG have a poor prognosis, and the elderly DLBCL patients treated with CHOP regimen and rituximab have a better prognosis.

Objective To study the incidence of positive t(14;18) and myc gene rearrangement, and the clinical features and prognosis of concurrent positive t ( 14;18 ) and myc gene rearrangement“ double-hit lymphoma” (DHL) in diffuse large B cell lymphoma.Me thods The positive t(14;18) and myc gene rearrangement in 106 cases of DLBCL were analyzed using interphase fluorescent in situ hybridization ( FISH ) technique. The expression of myc and bcl-2 proteins was determined by immunohistochemistry.The relationship of positive t ( 14;18) and myc gene rearrangement with clinical features, pathogenesis and prognosis for the patients was analyzed.SPSS 16.0 software was used for statistical analysis.Results Among the 106 cases, there were 27 (25.5%) cases with positive t(14;18) and 13 (12.3%) cases with myc gene rearrangement, and 7 cases (6.6%) of DLBCL with concurrent t(14; 18)-positive and myc gene rearrangement.A relationship was observed between positive t ( 14;18 ) and myc gene rearrangement ( P=0.019) .The follow-up data showed that the 7 DHL patients were in age of 528-4 years, the International Prognostic Index (IPI) scores were 3 in two cases, 4 in four cases and 5 in one case, and the ECOG scores were 3 in all the7 cases .Four patients had bone marrow involvement and were combined with leukemia.The survival time ranged from 0.5 to 6 months, with a median survival of 4 months.The univariate analysis showed that B symptom, Ann Arbor stage, ECOG score, LDH level, IPI score, immunophenotype, bcl-2 protein expression, myc protein expression,and myc gene rearrangement were all associated with poor prognosis ( P<0.05 for all) .The multivariate analysis using a COX proportional hazard model confirmed that ECOG score, bcl-2 protein expression, myc protein expression , myc gene rearrangement, and immunophenotype were independent prognostic factors affecting survival ( P<0.05 for all) , among them, the myc gene rearrangement was the strongest prognostic factor ( OR=4.337,P<0.001) . Conclusions “Double-hit” DLBCL is rare and can be mainly identified only by molecular detection.Perhaps positive t(14;18) and myc gene rearrangement play concurrent role in its “double-hit” pathogenesis.DHL are highly invasive, and most of DHL patients have poor prognosis.Further studies of larger case number are required to determine the pathologic features and the therapeutic strategy of this subgroup.

Objective To evaluate the clinical value of PET-CT and DWI for the detection of bone marrow infiltration of lymphoma .Methods The bone marrow samples of 93 untreated patients with pathologically diagnosed lymphoma were retrospectively analyzed . 61 patients underwent PET-CT examination, and other 32 underwent DWI examination .With bone marrow biopsy results as “gold standard”, the rates and sites of bone marrow infiltration of various lymphoma subtypes were analyzed , and the detection rates of the two imaging techniques were compared according to different lymphoma subtypes . Results 39 patients were diagnosed as bone marrow infiltration based on pathological examination of bone marrow biopsies from routine sampling sites and bone marrow pathological examination of biopsies guided by PET-CT and DWI.The sensitivity, specificity, accuracy, positive and negative predictive values of PET-CT for lymphoma bone marrow infiltration were 80.8%, 88.6%, 85.3%, 84.0%and 86.1%, respectively; for DWI examination, these rates were 84.6%, 89.5%, 87.5%, 84.6%and 89.5%, respectively.The detection rates of the two imaging techniques for aggressive lymphoma were 37.5%(18/48) and 38.1%(8/21), respectively, which were slightly higher than those for the indolent lymphoma [23.1%(3/13) and 27.3%(31/1)], although the differences were not statistically significant (P=0.521, P=0.660).For both aggressive lymphoma and indolent lymphoma , the detection rates of DWI were numerically slightly higher than those of PET-CT(P=0.963, P=1.000).Conclusions PET-CT and DWI have important and similar diagnostic value for bone marrow infiltration of lymphoma .None of PET-CT and DWI can replace bone marrow biopsy (BMB).However, image-guided bone marrow biopsies can improve the detection rate of bone marrow infiltration of lymphoma .

Objective To study the incidence of positive t(14;18) and myc gene rearrangement, and the clinical features and prognosis of concurrent positive t ( 14;18 ) and myc gene rearrangement“ double-hit lymphoma” (DHL) in diffuse large B cell lymphoma.Me thods The positive t(14;18) and myc gene rearrangement in 106 cases of DLBCL were analyzed using interphase fluorescent in situ hybridization ( FISH ) technique. The expression of myc and bcl-2 proteins was determined by immunohistochemistry.The relationship of positive t ( 14;18) and myc gene rearrangement with clinical features, pathogenesis and prognosis for the patients was analyzed.SPSS 16.0 software was used for statistical analysis.Results Among the 106 cases, there were 27 (25.5%) cases with positive t(14;18) and 13 (12.3%) cases with myc gene rearrangement, and 7 cases (6.6%) of DLBCL with concurrent t(14; 18)-positive and myc gene rearrangement.A relationship was observed between positive t ( 14;18 ) and myc gene rearrangement ( P=0.019) .The follow-up data showed that the 7 DHL patients were in age of 528-4 years, the International Prognostic Index (IPI) scores were 3 in two cases, 4 in four cases and 5 in one case, and the ECOG scores were 3 in all the7 cases .Four patients had bone marrow involvement and were combined with leukemia.The survival time ranged from 0.5 to 6 months, with a median survival of 4 months.The univariate analysis showed that B symptom, Ann Arbor stage, ECOG score, LDH level, IPI score, immunophenotype, bcl-2 protein expression, myc protein expression,and myc gene rearrangement were all associated with poor prognosis ( P<0.05 for all) .The multivariate analysis using a COX proportional hazard model confirmed that ECOG score, bcl-2 protein expression, myc protein expression , myc gene rearrangement, and immunophenotype were independent prognostic factors affecting survival ( P<0.05 for all) , among them, the myc gene rearrangement was the strongest prognostic factor ( OR=4.337,P<0.001) . Conclusions “Double-hit” DLBCL is rare and can be mainly identified only by molecular detection.Perhaps positive t(14;18) and myc gene rearrangement play concurrent role in its “double-hit” pathogenesis.DHL are highly invasive, and most of DHL patients have poor prognosis.Further studies of larger case number are required to determine the pathologic features and the therapeutic strategy of this subgroup.

Objective To evaluate the clinical value of PET-CT and DWI for the detection of bone marrow infiltration of lymphoma .Methods The bone marrow samples of 93 untreated patients with pathologically diagnosed lymphoma were retrospectively analyzed . 61 patients underwent PET-CT examination, and other 32 underwent DWI examination .With bone marrow biopsy results as “gold standard”, the rates and sites of bone marrow infiltration of various lymphoma subtypes were analyzed , and the detection rates of the two imaging techniques were compared according to different lymphoma subtypes . Results 39 patients were diagnosed as bone marrow infiltration based on pathological examination of bone marrow biopsies from routine sampling sites and bone marrow pathological examination of biopsies guided by PET-CT and DWI.The sensitivity, specificity, accuracy, positive and negative predictive values of PET-CT for lymphoma bone marrow infiltration were 80.8%, 88.6%, 85.3%, 84.0%and 86.1%, respectively; for DWI examination, these rates were 84.6%, 89.5%, 87.5%, 84.6%and 89.5%, respectively.The detection rates of the two imaging techniques for aggressive lymphoma were 37.5%(18/48) and 38.1%(8/21), respectively, which were slightly higher than those for the indolent lymphoma [23.1%(3/13) and 27.3%(31/1)], although the differences were not statistically significant (P=0.521, P=0.660).For both aggressive lymphoma and indolent lymphoma , the detection rates of DWI were numerically slightly higher than those of PET-CT(P=0.963, P=1.000).Conclusions PET-CT and DWI have important and similar diagnostic value for bone marrow infiltration of lymphoma .None of PET-CT and DWI can replace bone marrow biopsy (BMB).However, image-guided bone marrow biopsies can improve the detection rate of bone marrow infiltration of lymphoma .

OBJECTIVE To investigate the incidence of nosocomial infection in ICU patients,risk factors.and measures to prevent infection.METHODS The nosocomial infection of ICU patients in the hospitals from Nov 2005 to Jun 2009 was investigated using the method of target monitoring.The nosocomial infection rate was regulated by the method of ASA.The invasive procedure and the associated infection rate were analyzed.RESULTS Among 833 inpatients in ICU,92 suffered from nosocomial infection,The nosocomial infection rate was 11.04%.and the nosocomial infection rate per day was 4.43% after modified by the method of ASA.The incidence of patients was 5.37%.Totally 145 strains of bacteria were isolated,and the dominant pathogens were Gram-negative bacilli(56.55%).CONCLUSIONS The patients in ICU are susceptible population of nosocomial infection,A.baumannii is the dominating pathogen to cause nosocomial infection in intensive care units.Target monitoring in ICU is an effective surveillance method to reduce the prevalence of nosocomial infection.