Objective:To investigate the clinicopathological and genetic characteristics of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL).Methods:The forty-two MEITL cases diagnosed in the Department of Pathology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China from 2016 to 2022 was retrospectively analyzed. Clinical data were collected, and follow-up was performed. Morphological characteristics were observed. Immunohistochemistry, Epstein-Barr virus (EBV) in situ hybridization, clonal rearrangement analysis of T-cell receptor (TCR) genes, and targeted next-generation sequencing (NGS) were performed.Results:Among the 42 patients (male/female ratio of 2.8∶1.0), the age range was 32-77 years with a median age of 59.5 (52.0-65.0) years. Grossly, the tumors were presented as ulcerative or exophytic lesions, with a maximum diameter of 2-18 cm. There were 34 cases with a single lesion and 8 cases with more than 1 lesion. The tumor cells in all 42 cases were relatively monotonous in histology and small or medium in size. They had round or oval nuclei, moderately pale or clear cytoplasm, evenly distributed nuclear chromatin, inconspicuous nucleoli, and frequent mitotic figures. In one of the cases, there were moderately large cells, vacuolated nuclei, and clear nucleoli. Lymphoepithelial lesions were observed in 36 (85.7%) of the 42 cases, tumor necrosis in 4 (9.5%) cases, scattered eosinophils and/or plasma cell infiltration in the background in 9 (21.4%) cases, and a "starry sky" phenomenon in 1 (2.4%) case. The tumor cells in all cases exhibited high expression of CD3, CD2, CD7, CD8, CD56, TIA1, Granzyme B, and Perforin, while some also expressed CD4 (5/41, 12.2%), CD5 (3/41, 7.3%), CD20 (4/41, 11.9%), CD79α (2/37, 5.4%), and CD30 (1/34, 2.9%). The Ki-67 proliferation index ranged from 40% to 90%. EBER in situ hybridization tests were negative in all cases. TCR gene clonal rearrangement was detected in 96.4% (27/28) of the tested cases. Targeted NGS revealed commonly mutated genes including SETD2, STAT5B, JAK3, TP53, and CREBBP. The primary treatment was chemotherapy, with 2 cases undergoing autologous hematopoietic stem cell transplantation. Follow-up information was obtained for 29 cases, with a follow-up period of 1-73 months. The mortality was 93.1% (27/29).Conclusions:MEITL is a rare and highly aggressive peripheral T-cell lymphoma. Its clinical manifestations are diverse, and diagnosis primarily relies on a comprehensive assessment of pathological morphology, immunohistochemical profiles, and EBV infection status, supplemented by genetic testing if necessary. At present, there is no effective treatment, and its overall prognosis is poor.

Objective:To investigate the clinicopathological and genetic characteristics of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL).Methods:The forty-two MEITL cases diagnosed in the Department of Pathology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China from 2016 to 2022 was retrospectively analyzed. Clinical data were collected, and follow-up was performed. Morphological characteristics were observed. Immunohistochemistry, Epstein-Barr virus (EBV) in situ hybridization, clonal rearrangement analysis of T-cell receptor (TCR) genes, and targeted next-generation sequencing (NGS) were performed.Results:Among the 42 patients (male/female ratio of 2.8∶1.0), the age range was 32-77 years with a median age of 59.5 (52.0-65.0) years. Grossly, the tumors were presented as ulcerative or exophytic lesions, with a maximum diameter of 2-18 cm. There were 34 cases with a single lesion and 8 cases with more than 1 lesion. The tumor cells in all 42 cases were relatively monotonous in histology and small or medium in size. They had round or oval nuclei, moderately pale or clear cytoplasm, evenly distributed nuclear chromatin, inconspicuous nucleoli, and frequent mitotic figures. In one of the cases, there were moderately large cells, vacuolated nuclei, and clear nucleoli. Lymphoepithelial lesions were observed in 36 (85.7%) of the 42 cases, tumor necrosis in 4 (9.5%) cases, scattered eosinophils and/or plasma cell infiltration in the background in 9 (21.4%) cases, and a "starry sky" phenomenon in 1 (2.4%) case. The tumor cells in all cases exhibited high expression of CD3, CD2, CD7, CD8, CD56, TIA1, Granzyme B, and Perforin, while some also expressed CD4 (5/41, 12.2%), CD5 (3/41, 7.3%), CD20 (4/41, 11.9%), CD79α (2/37, 5.4%), and CD30 (1/34, 2.9%). The Ki-67 proliferation index ranged from 40% to 90%. EBER in situ hybridization tests were negative in all cases. TCR gene clonal rearrangement was detected in 96.4% (27/28) of the tested cases. Targeted NGS revealed commonly mutated genes including SETD2, STAT5B, JAK3, TP53, and CREBBP. The primary treatment was chemotherapy, with 2 cases undergoing autologous hematopoietic stem cell transplantation. Follow-up information was obtained for 29 cases, with a follow-up period of 1-73 months. The mortality was 93.1% (27/29).Conclusions:MEITL is a rare and highly aggressive peripheral T-cell lymphoma. Its clinical manifestations are diverse, and diagnosis primarily relies on a comprehensive assessment of pathological morphology, immunohistochemical profiles, and EBV infection status, supplemented by genetic testing if necessary. At present, there is no effective treatment, and its overall prognosis is poor.

Objective To explore the causal relationship between educational attainment and chronic kidney disease(including chronic glomerulonephritis,nephrotic syndrome,diabetic nephropathy,chronic renal failure,and other clinical diagnoses of chronic kidney disease),and provide targeted guidance support for different populations in the prevention and treatment of chronic kidney disease.Methods The study used four regression models,random-effects inverse-variance weighted(IVW),MR-Egger regression,weighted median method,and weighted model,to perform Mendelian randomization analysis of the causal relationship between educational attainment and chronic kidney disease.Results All four regression models showed no statistical significance for the three models of chronic kidney disease,chronic glomerulonephritis,and nephrotic syndrome with P>0.05.The diabetic nephropathy model was seen to be statistically significant as the results of the three methods except IVW method(OR=0.520,P<0.05)were not significant,while the scatter plot showed that the direction of the total effect value was the same for all methods.Chronic renal failure model IVW method(OR=0.487,P<0.001),weighted median method(OR=0.503,P<0.001)showed a significant effect and the scatter plot showed that the direction of the total effect value was the same in all methods,which was statistically significant.Conclusion Using two-sample Mendelian randomization method to exclude confounding factors and reverse causal associations,unbiased estimation results were obtained to get that the education level is not related to the overall chronic kidney disease incidence,but has reverse causality for diabetic nephropathy and chronic renal failure among them.

OBJECTIVE:To establish a GC-MS method to identify the volatile constituents in Radix Isatidis.METHODS:The method of wet distillation was applied to extracting volatile oil from Radix Isatidis,the chromatographic column was OV-1,and the flow rate was 1.0mL?min-1,EI ion source was used by MS.The volatile constituents in Radix Isatidis were identified and analyzed by NIS107 system.RESULTS:22 chromatographic peaks were separated,19 chemical compounds were identified,representing 90.51% of total amount,hexadecanoic acid had highest content,accounting for 38.52% of total amount.CONCLUSION:This experiment has provided initial usable data for comprehensive utilization of Radix Isatidis.

This paper reviews twenty-eight Chinese medicine books with complete prescriptions prior to the Qing Dynasty, and analyzes the characteristics of acupoint selection and needling manipulations from the perspective of apoplectic symptoms. It is concluded that,in ancient times, apoplexy is often treated on the basis of its symptoms and a great number of acupoints are employed; hemiplegia is mainly treated by the acupoints of the Large Intestine Meridian and Gallbladder Meridian,with two key acupoints; coma is mainly treated by first-aid acupoints and qi-supplementing acupoints, with seven key acupoints; wry mouth and convulsion are mainly treated by the local acupoints; as for needling manipulations, moxibustion with moxa cones is principally used, while needling is less used.