Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.

Objective:To construct a simple model of arteriovenous fistula classification,and to achieve the classification of arteriovenous fistula in hemodialysis patients.Methods:The study was a retrospective analysis, a total of 304 hemodialysis patients with internal fistula in People′s Hospital of Deyang City from January 2016 to January 2021 were selected by convenience sampling method,depending on whether the internal fistula was dysfunctional, patients were divided into 64 in the internal fistula failure group and 240 in the internal fistula patency group. Independent influence factors and their regression coefficient were obtained by single-factor analysis and logistic regression analysis, The risk score formula was established based on the regression coefficient to form a simple model of internal fistula classification.The model was evaluated by receiver operating characteristic curve and the scoring criteria for internal fistula classification was determined.Results:Logistic regression analysis showed that diabetes mellitus, hypotension, age≥60 years old, compression time≥30 min, blood phosphorus>1.78 mmol/L, triglyceride>1.71 mmol/L and fibrinogen>4 g/L were independent influencing factors of internal fistula failure (all P<0.05).The area under the receiver operating characteristic curve was 0.858(95% CI 0.789-0.928, P<0.01), and the best critical value of the internal fistula classification was 7.5, the sensitivity was 80.4% and the specificity was 84.8%. Conclusions:By obtaining the predictors of internal fistula failure, conducted the risk score, and constructed a simple model of internal fistula classification, which can effectively predicted the risk of internal fistula failure. It is conducive to the implementation of internal fistula classification management and the puncture of corresponding grade, to ensure the pathway safety of patients.

Objective:To establish a prediction model of acute gastrointestinal injury (AGI) above grade II in elderly patients with severe pneumonia, and to evaluate and validate the model internally.Methods:A retrospective analysis was performed on 268 patients aged >65 years with severe pneumonia admitted to the Second People′s Hospital of Hefei from June 2019 to May 2022 (207 cases in the training set and 61 cases in the verification set). Sixteen indicators, including age, sex, underlying disease, pneumonia Severity index (PSI) score, dosage of sedative and analgesic drugs, and mechanical ventilation time of all patients were collected. After logistic regression analysis in the training set, a model was established to predict AGI above grade Ⅱ in elderly patients with severe pneumonia. Receiver operating characteristic (ROC) curve was drawed and correction curve was used to evaluate the reliability of the model. The model was internally validated by validation set data.Results:Among 207 patients with severe pneumonia in the training set, 50 patients developed AGI above grade Ⅱ during treatment. The prediction model was established by logistic regression analysis as follows: When L=Sequential Organ Failure Assessment (SOFA)×0.181+ PSI score×0.066+ propofol dosage×0.607+ reifentanil dosage×1.187, L>19.288, it can be considered that patients with severe pneumonia have a 93.24% chance of developing grade Ⅱ or above AGI. The ROC curve showed that the model was well differentiated, AUC=0.960. H-L test indicated (χ 2=7.39, P=0.496>0.05) the model fit was good. The sensitivity and specificity of the model were 82.00% and 96.82% respectively. AUC=94.58% (sensitivity 81.25%, specificity 93.33%), H-L test indicated ( χ 2=4.51, P=0.808>0.05) the prediction accuracy was 90.16%. Conclusions:The prediction model for AGI after severe pneumonia in elderly patients can be used clinically to help predict the occurrence of AGI in elderly patients with multiple injuries.

Objective:To analyze the characteristics and risk factors of previous low-energy fractures in elderly patients with hip fractures admitted to our hospital.Methods:The data for this study was collected from 596 hip fracture patients admitted to Zhongda Hospital Affiliated to Southeast University between January 2018 and December 2021.Out of these patients, there were 404 females and 192 males.Based on the history of low-energy fracture before hip fracture, the patients were divided into two groups: a low-energy fracture group and a non-low-energy fracture group.A comparison was made between the two groups in terms of gender, age, fracture type, BMI, number of combined medical diseases, ASA score, and other characteristics.Results:The study included a total of 596 patients, with 368 patients having no history of low-energy fractures and 228 patients with low-energy fractures.Among the patients with low-energy fractures, there were 118 vertebral fractures, 69 hip fractures, 57 rib fractures, 19 radial fractures, 14 humerus fractures, and 12 patella fractures.Univariate analysis revealed significant differences in age, gender, fracture type, number of combined medical diseases, and ASA score between the two groups( P<0.05 for all). The results of multivariate Logistic analysis indicated that age( OR=1.046, 95% CI: 1.022-1.070), female sex( OR=1.474, 95% CI: 1.011-2.148), and the number of comorbid medical diseases( OR=1.211, 95% CI: 1.113-1.318)were independent risk factors for patients with a history of low-energy fractures. Conclusions:Our findings provide evidence that vertebral, hip, and rib fractures were the three most common previous low-energy fractures in elderly patients with hip fractures.We identified age, female gender, and number of medical diseases as independent risk factors for prior low-energy fractures in this population.

Objective:To analyze the risk factors for postoperative one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment (MDT) by intramedullary nailing.Methods:The clinical data were retrospectively analyzed of the 158 elderly patients with femoral intertrochanteric fracture who had undergone MDT by proximal femoral intramedullary nailing between January 2018 and August 2020 at Department of Orthopedics, Trauma Center, Zhongda Hospital Affiliated to Southeast University. There were 41 males and 117 females with an average age of 82.5 years (from 65 to 95 years). By the modified Evans classification, there were 15 cases of type Ⅰ, 16 cases of type Ⅱ, 35 cases of type Ⅲ, 81 cases of type Ⅳ, and 11 cases of type Ⅴ. The one-year mortality was documented in the patients after surgery. To screen for risk factors, univariate analysis was conducted of gender, age, body mass index (BMI), modified Evans classification of fractures, time from injury to operation, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI) and comorbidities, as well as preoperative hemoglobin (Hb), serum albumin (ALB) and total lymphocyte count (TLC). The factors with P<0.05 were included in the multivariate logistic regression model analysis to determine the risk factors. Results:A total of 13 patients died within one year after surgery, yielding a mortality of 8.2% (13/158). Univariate analysis showed significant differences in age, body mass index, modified Evans classification of fractures, CCI and Hb between the surviving and dead patients ( P<0.05). Multivariate logistic regression analysis showed that age >85 years ( OR=0.122, 95% CI: 0.018 to 0.834, P=0.032), BMI>23.9 kg/m 2 ( OR=0.083, 95% CI: 0.013 to 0.510, P=0.007), CCI≥3 points ( OR=0.051, 95% CI: 0.090 to 0.275, P=0.001) and preoperative Hb<90 g/L ( OR=4.733, 95% CI: 1.036 to 21.624, P=0.045) were the independent risk factors for postoperative one-year mortality in the elderly patients with intertrochanteric fracture following MDT by proximal femoral intramedullary nailing. Conclusions:After MDT by proximal femoral intramedullary nailing of femoral intertrochanteric fractures, the geriatric patients with an age >85 years, BMI>23.9 kg/m 2, CCI≥3 points and Hb<90 g/L are likely to die. Therefore, special care should be taken for them.

The prognosis of elderly (>60 years) patients with diffuse large B-cell lymphoma (DLBCL) is significantly worse compared with young patients, and there is currently no standard treatment. Elderly patients with DLBCL are highly heterogeneous, a stratification before treatment can help achieve precise medicine and improve outcome of them. R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin and prednisolone) is still the recommended treatment for fit elderly DLBCL patients; and for unfit or very old patients, chemotherapy of reduced dose or palliative treatments should be considered. Choices for relapsed or refractory patients are limited, and novel compounds or therapies that are well tolerated may have a good application prospect.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a kind of rare and highly invasive hematological malignancy. Because of its low incidence, there is still no consensus on its standard treatment. For young patients, high intensity chemotherapy combined with hematopoietic stem cell transplantation is often used. Elderly patients who cannot accept hematopoietic stem cell transplantation receive low intensity chemotherapy. In December 2018, tagraxofusp, a new targeted drug, was approved by the U. S. Food and Drug Administration specially for treatment-naive and previously-treated BPDCN patients (age≥2 years old). Some targeted drugs, such as venetoclax and daratumumab, have certain effects on the treatment of BPDCN. The efficacies of PD-1/PDL-1 inhibitors and anti CD123 chimeric antigen receptor T cell immunotherapy need further researches.

Indolent B-cell lymphoma is still an incurable disease. However, with the further understanding of the pathogenesis of B-cell lymphoma in recent years, the number of treatment drugs and protocols for indolent B-cell lymphoma is increasing, including targeted drugs CD20 monoclonal antibody, BTK inhibitors, immunosuppressive agents, proteasome inhibitors, immune checkpoint inhibitors, which may have effects on the future treatment strategies. This paper summarizes the key clinical trials of targeted therapies for indolent B-cell lymphoma according to the 59th American Society of Hematology Annual Meeting.

The occurrence and development of some lymphomas are closely related to EB virus, including B cell lymphoma, NK/T cell lymphoma, Hodgkin lymphoma and post-transplant lymphoproliferative disorder. Many studies have shown that some gene expression products that related to EB virus latent infection play a crucial role in the development of lymphoma. In this paper, the structure and biological characteristics of EB virus, its gene expression products, the mechanism of tumorigenesis and the related lymphomas are reviewed.

Objective To investigate the clinical manifestations and surgical effectiveness of the primary retroperitoneal teratoma in infants.Methods The records of 36 patients were retrospectively reviewed who were diagnosed as primary retroperitoneal teratoma and treated at the Department of Pediatric Oncology,Guangzhou Women and Children's Medical Center between August 2015 and August 2017.The related data were collected,including gender,age,operation time,operational bleeding and tumor weight.All patients took the ultrasound,computed tomography (CT) before surgery,alpha-fetal protein (AFP) and human chorionic gonadotrophin(HCG) were detected during peri-operation period.All cases were classified into 0 to Ⅲ grades according to the Norris classification (27 patients of 0 grade,1 patient of Ⅰ grade,4 patients of Ⅱ grade,4 patients of Ⅲ grade).Results There were 9 males and 27 females in the study.All patients were treated surgically at the age of 11.4 months (7 days-7 years) on the average;the mean weight of incised tumor was 736.47 g (7.90-2 355.00 g);operation time was 2.88 hours (1.08-7.06 hours);the amount of bleeding during operation was 29.11 mL (2-150 mL).All patients received follow-ups for 6.56 months (9 days-23 months) on the average.Radiographs found that tumors in 25 patients (69.4％) were located in the left side of the abdominal cavity,and the rest of them were located in the right side.In addition,tumors in 30 patients (83.3 ％) were big enough to pass across the mid-line of the body.Average pre-operation AFP was 7 593.1 μg/L(1.7-80 000.0 μg/L),post-operation AFP was 1 339.5 μg/L(1.4-16 519.6 μg/L),and the difference was statistically significant (P =0.001);pre-operation AFP of the mature group was 5 439.6 μg/L(1.7-80 000.0 μg/L),post-operation AFP of the mature group was 1 130.6 μg/L(1.4-16 519.6 μg/L),and the difference was statistically significant (P =0.001);pre-operation AFP of the immature group [11 182.3 μg/L(17.4-80 000.0 μg/L)] was higher than that of the mature group,and the difference was statistically significant(P =0.006).On the final follow-up,AFP was mean 38.3 μg/L (1.4-352.4 μg/L);among them,AFP of the mature group was mean 14.3 μg/L (1.4-43.3 μg/L),the immature group was 78.4 μg/L(1.7-325.4 μ g/L),and the difference was statistically significant(P =0.028);AFP of 4 patients in the immature group who underwent chemotherapy was 54.9 μg/L (2.6-116.6 μg/L)on the average,lower than those of post-operation AFP of 265.2 μg/L (206.8-384.1 μg/L),and the difference was statistically significant (P =0.042).All patients were treated surgically,and 3 cases of them received laparoscope technique;no significant relationship was proved between time of surgery and the tumor weight,location,and Norris classification(all P ＞ 0.05).The incidence rate of the surgical complications was 42.1％,such as tumor rupture (6 patients),vascular injury (5 patients),digestive tract damage (4 patients) and incomplete incision (1 patient).There was no death case in the serials.Conclusions Primary retroperitoneal teratoma can be completely incised.However,the complications of surgery could appear in many cases.As a predictive index for the recurrence retroperitoneal teratoma,AFP can be diminished by chemotherapy following the surgery.