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Hemophagocytic syndrome (HPS), which is currently named as hemophagocytic lymphohistiocytosis (HLH), is a hyperinflammatory syndrome characterized by persistent fever, hepatosplenomegaly, pancytopenia and hemophagocytosis found in bone marrow, liver, spleen and lymph nodes due to excessive activation of macrophages and cytotoxic T cells. Macrophage activation syndrome (MAS) is a specific form of HLH induced by autoinflammatory/autoimmune disorders which can be life-threatening and requires multiple disciplines. In order to improve clinicians′ understanding of MAS and standardize the clinical diagnosis and treatment practice of MAS, the rheumatology branch of Chinese Rheumatology Association organized domestic experts to formulate the diagnosis and treatment standard, in order to improve the diagnosis and treatment level of MAS and improve the prognosis of patients.
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Objective:To construct a home-based cardiac rehabilitation intervention system for patients after percutaneous coronary intervention, and to provide reference for improving the self-management ability and family support of home-based cardiac rehabilitation of patients after PCI.Methods:Based on the literature study and group discussions, a draft of home-based cardiac rehabilitation intervention system for patients after PCI based on empowerment theory was constructed. From January to April 2021, the Delphi method was used to conduct 2 rounds of expert consultations among 18 experts from 9 hospitals, and the items were modified according to the experts′ advice.Results:The expert positive coefficients of the 2 rounds were 94.44% and 100.00%, the expert authority coefficients was 0.91, and the Kendall coefficients were 0.188 and 0.255. Finally, a home-based cardiac rehabilitation intervention system for patients after PCI was formed, including 5 first-level items, 19 second-level items and 21 third-level items.Conclusion:The home-based cardiac rehabilitation intervention system for patients after PCI is reliable, scientificity and practical, and has guiding significance for promoting the development of home-based cardiac rehabilitation for PCI patients.
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Objective:To prepare a drug release system of drug-loaded cross-linked decellularized corneal stromal lenticules and evaluate its drug release characteristics in vitro. Methods:Lenticules were obtained during femtosecond laser-assisted small incision lenticule extraction (SMILE) surgery in Chongqing Aier Ophthalmology Hospital.Decellularized corneal stromal lenticules were prepared using high concentration sodium chloride (NaCl) combining nuclease.The decellularized corneal stromal lenticules were randomly divided into normal group, 0.5% levofloxacin group, 3% levofloxacin group and 5% levofloxacin group, with 4 lenticules in each group.The lenticules did not receive any treatment in the normal group, and drug-loading those were soaked in different doses of levofloxacin solution for three hours according to grouping.In the crosslinking test, 12 decellularized corneal stromal lenticules were randomly divided into non-crosslinking group, 0.01 mmol 1-(3-dimethylamino) propylimine (EDC) group, 0.05 mmol EDC group and 0.25 mmol EDC group.The lenticules for cross-linking were soaked in different contents of mixed solution of EDC with N-hydroxysuccinyl (NHS) for four hours respectively according to grouping, and then in 3% levofloxacin solution for three hours.Only 3% levofloxacin solution soaking was carried in the non-crosslinking group.High performance liquid chromatography (HPLC) was employed to detect the drug release concentration of the lenticules, and spectral scanning method was performed to measure light transittance of the lenticules.The surface ultrastructure of the decellularized lenticules among different cross-linking groups was examined and compared with scanning electron microscope.The use of the human corneal lenticules was approved by an Ethics Committee of Chongqing Aier Ophthalmology Hospital (No.2019012). Written informed consent was obtained from each patient before surgery.Results:The release concentrations of decellularized corneal stroma lenticules were significantly different at 1 day, 7, 14, and 21 days among 0.5%, 3%, and 5% levofloxacin group ( P<0.05) or also among the 0.01 mmol EDC, 0.05 mmol EDC, and 0.25 mmol EDC cross-linked groups ( P<0.01). The drug release concentrations in 0.05 mmol EDC group were the highest at various time points, and the release time of the three cross-linked groups lasted until 21 days after release concentrations of decellularized corneal stroma lenticules.The drug release concentrations in cross-linked groups and non-crosslinking group were gradually declined with the prolong of drug-loading time, showing a significant difference at different time points ( P<0.05). The transmittance of the lenticules was (88.68±1.19)% and (91.55±1.16)% in the non-crosslinking group and normal group, respectively, with no significant difference ( P>0.05). The average transmittance of the lenticules was significantly reduced in the drug-loaded groups compared with the normal group ( P<0.05). The smaller collagen fiber voids and closely arranged collagen fibers were displayed in the cross-linking groups under the scanning electron microscope with the best effect in the 0.25 mmol EDC group. Conclusions:EDC/NHS cross-linking can improve the drug-loading effect of decellularized corneal stromal lenticules probably by lessening collagen fiber voids.The drug-loaded cross-linked decellularized corneal stromal lenticules have a good drug release effect in vitro.
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Objective:To analyze the clinical characteristics of chronic granulomatous disease (CGD) with chronic active EB virus (EBV) infection (CAEBV).Methods:The clinical data of 1 CGD patient combined with CAEBV who underwent allogeneic hematopoietic stem cell transplantation (HSCT) in Beijing Friendship Hospital of Capital Medical University in March 2017 was retrospectively analyzed, and the relevant literature was also summarized.Results:After transplantation, the chimeric rate and gene test was 100% complete donor type. During the follow-up period, no recurrent severe infection occurred within 39 months, and EBV-DNA copy was 0; no acute or chronic graft-versus-host disease (GVHD) related manifestations occurred, and the quality of life was higher.Conclusions:Haploid allogeneic HSCT with myeloablative conditioning regimens is a relatively safe and effective treatment for CGD patients combined with CAEBV. For primary immunodeficiency disease, it suggests that the haploidentical donor carrying the monohybrid pathogenic gene can also be used as an effective stem cell source if the hematological and immunological function is normal.
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Objective@#To explore the efficacy and prognostic factors of hematopoietic stem cell transplantation (HSCT) for the treatment of patients with anaplastic large cell lymphoma (ALCL) .@*Methods@#The clinical records of 33 ALCL patients after HSCT were collected and analyzed retrospectively to evaluate the rates of overall survival (OS) and recurrence after autologous (auto-HSCT) and allogeneic HSCT (allo-HSCT) and the factors influencing prognosis.@*Results@#The median-age of this cohort of 33 ALCL cases at diagnosis was 31 (12-57) years old with a male/female ratio of 23/10, 24 cases (72.7%) were ALK+ and 9 ones (27.3%) ALK-. Of them, 25 patients (19 ALK+ and 6 ALK-) underwent auto-HSCT and 8 cases (5 ALK+ and 3ALK-) allo-HSCT with a median follow-up of 18.7 (4.0-150.0) months. Disease states before HSCT were as follows: only 6 patients achieved CR status and received auto-HSCT, 16 patients achieved PR (14 cases by auto-HSCT and 2 ones allo-HSCT) , the rest 11 cases were refractory/relapse (5 cases by auto-HSCT and 6 ones allo-HSCT) . There were 7 cases died of disease progression (5 after auto-HSCT and 2 allo-HSCT) and 5 cases treatment-related mortality (TRM) (2 after auto-HSCT and 3 allo-HSCT) , TRM of two groups were 8.0% and 37.5%, respectively. Both the median progression-free survival (PFS) and OS were 15 months after auto-HSCT, the median PFS and OS after allo-HSCT were 3.7 (1.0-90.0) and 4.6 (1.0-90.0) months, respectively. There was no statistically significant difference in terms of survival curves between the two groups (OS and PFS, P=0.247 and P=0.317) . The 2-year OS rates in auto-HSCT and allo-HSCT groups were 72% and 50%, respectively. The 5-year OS rates in auto-HSCT and allo-HSCT groups were 36% and 25%, respectively.@*Conclusion@#ALCL treated by chemotherapy produced high rates of overall and complete responses. Chemotherapy followed by auto-HSCT remained to be good choice for patients with poor prognostic factors. High-risk patients should be considered more beneficial from allo-HSCT.
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Objective@#To evaluate clinical outcomes of autologous (auto-HSCT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) for angioimmunoblastic T-cell lymphoma (AITL) .@*Methods@#From June 2007 to June 2017, clinical data of AITL patients who underwent HSCT in eight hospitals were assessed retrospectively.@*Results@#Of 19 patients, 13 male and 6 female with a median age of 50 (32-60) years old, 12 auto-HSCT and 7 allo-HSCT recipients were enrolled in this study, all donors were HLA-identical siblings. Two of allo-HSCT recipients were relapsed auto-HSCT ones. There were 5 patients (5/12) in complete response (CR) status and 7 (7/12) in partial remission (PR) status before transplantation in auto-HSCT group, and 2 (2/7) in PR status and 3 (3/7) in progression disease (PD) status before transplantation in allo-HSCT group. The median follow-up for the surviving patients was 46.5 months (range, 1-100 months) for the whole series, two patients lost in auto-HSCT group. Three patients developed acute graft-versus-host disease (aGVHD) and 5 chronic graft-versus-host disease (cGVHD) after allo-HSCT. Three patients died of primary disease and 1bleeding in auto-HSCT group. One patient died of primary disease and 2 transplantation-related mortality in allo-HSCT group. The 3-year cumulative overall survival (OS) were 56% (95%CI 32%-100%) and 57% (95%CI 30%-100%) for auto-HSCT and allo-HSCT, respectively (P=0.979) . The 3-year cumulative progression-free survival (PFS) were 34% (95%CI 14%-85%) and 57% (95%CI 30%-100%) for auto-HSCT and allo-HSCT, respectively (P=0.451) .@*Conclusion@#Both auto-HSCT and allo-HSCT were optimal choices for AITL. In clinical practice, which HSCT was better for AITL patients should be based on comprehensive factors including sensitivity to chemotherapy, risk stratification and disease status at transplantation.
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Objective To explore the value of single source dual energy CT for quantitative measurement of liver fat fraction in the rabbit model of nonalcoholic fatty liver disease(NAFLD).Methods Thirty male New Zealand rabbits were randomly divided into five groups.Six rabbits were fed with standard chow as a control group for 3 weeks.TwentyGfour rabbits were divided into four groups and fed with highGfat, highGcholesterol diet to reach different stage of NAFLD model for 1 ,3 ,4 and 8 weeks respectively before dualGenergy CT scanning.1 40 keV polychromatic CT values (QC),70 keV monochromatic CT values (Mono 70 keV),slope,effective atomic number (EffectiveGZ)and fat concentration based on dualGenergy CT fat decomposition (Fat/Water)were measured.Liver samples were obtained to measure the fat fraction and staged according to Burnt staging system.Correlations between different CT indexes and fat fraction were analyzed.ROC was used to evaluate the diagnosis efficacy of different parameters.Results Correlation between fat concentration based on dualGenergy CT fat decomposition and fat fraction (r＝0.936)was better than that between 140 keV polychromatic CT values (r＝－0.838)and 70 keV monochromatic CT values (r＝－0.906),as well as effective atomic number (r＝－0.858)and slope (r＝0.863).In terms of diagnostic performance of material decomposition fat imaging,the values of area under the curve were 0.944 (stage 0 vs.stage 1 or more severe),0.995 (stage 1 or less severe vs.stage 2 or more severe)and 1 (stage 2 or less severe vs.stage 3)with optimal cutoff values of 59.310,99.5 17 and 22 3.02 3 mg/cm3 ,respectively.Conclusion The dualGenergy CT can quantitatively measure liver fat concentration as a noninvasive surrogate bioGmarker in the rabbit model of nonalcoholic fatty liver disease.DualGenergy CT derived material decomposition fat images can provide more diagnostic information at the early stage of NAFLD.
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Objective To evaluate the clinicopathological characteristics and prognosis of cervical adenocarcinoma patients with stage Ⅰ b1-Ⅱ b treated with radical hysterectomy and systematic lymphadenectomy.Methods The clinical,pathologic and follow-up data of 118 cases of cervical adenocarcinoma with stage Ⅰ b1-Ⅱ b treated with radical hysterectomy and systematic lymphadenectomy in Cancer Hospital of Shantou University Medical College from Dec.2003 to Nov.2015 were analyzed retrospectively.Results 118 patients of cervical adenocarcinoma with stage Ⅰ b1-Ⅱ b had a median age of 46 years at diagnosis.28 cases were postmenopausal and 90 cases were premenopausal.There were 77 cases in phase Ⅰ b1,25 in stage Ⅰ b2,4 in stage Ⅱ a1,7 in stage Ⅱ a2,5 in stage Ⅱ b.The rate of ovarian metastasis was 3.39％.The 3-year recurrence-free survival rate of the patients was 81.6％.The 3-year overall survival rate of the patients was 83.9％,and 89.10％ for stage Ⅰ b1,73.7％for stage Ⅰ b2,100％ for stage Ⅱ a1,83.3％ for stage Ⅱ a2,60.0％ for stage Ⅱ b.The 3-year overall survival rates of the patients who receive non-chemoradiotherapy,chemotherapy,radiotherapy and chemoradiotherapy after operation were 90.6％,100％,84.6％ and 70％ respectively.The result of Cox proportional hazards regression model analysis indicated that lymph lode metastasis and ovarian metastasis was the independent prognostic factor of desease-free survival,ovarian metastasis and deep myometrial invasion was the independent prognostic factor of overall survival.Conclusions Premenopausal cases are more common than postmenopausal cases in cervical adenocarcinoma with stage Ⅰ b1-Ⅱ b.Ovarian presevation is feasible for early-stage cervical denocarcinoma after full assessment.Pelvic irradiation with concurrent chemotherapy can lead a better prognosis for the patients with pathological risk factors.
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Objective@#To explore the clinical features of patients with hemophagocytic lymphohistiocytosis (HLH) complicated with gastrointestinal bleeding.@*Methods@#The clinical data of 52 patients with HLH diagnosed from January 2015 to February 2017 were analyzed retrospectively.@*Results@#①Of the 52 patients[including 36 cases of EBV related (69.2%) , 5 cases of lymphoma related (9.6%) , 3 cases of primary HLH (5.8%) , 3 cases of rheumatism related (5.8%) , 2 cases of tuberculosis related (3.8%) , 3 cases of unknown causes (3.8%) ], 32 cases were male (61.5%) and 20 cases female (38.5%) with a median age of 26 (6-64) years old. ②The overall survival rates at 1, 3, 6 and 12 months were 74.7%, 53.8%, 32.9% and 23.3% respectively. ③Multivariate analysis (logistic regression) showed thrombocytopenia (P=0.036) and other sites of hemorrhage (P=0.030) were risk factors of poor prognosis, and allogeneic hematopoietic stem cell transplantation (allo-HSCT, P=0.026) was the influence of good prognostic factor.@*Conclusion@#HLH combined with gastrointestinal bleeding was an entity of disease with poor prognosis. Thrombocytopenia and other sites of bleeding had a significant negative impact on patients, allo-HSCT produced a significant positive impact on patients.
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Objective To analyze the clinical characteristics of adult patients with hemophagocytic lymphohistiocytosis (HLH) receiving haploidentical donor hematopoietic stem cell transplantation (HID HSCT).Method We retrospectively reviewed 20 adult patients with HLH from August 2009 to August 2014.The clinical features and outcome were analyzed.Results Conditioning regimens consisted of total body irradiation/etoposide/cyclophosphamide (TBI/VP-16/CTX) and busulfan (Bu)/VP-16/CTX in HLH with anti-thymocyte globulin (ATG) 8 mg/kg.The stem cells were mobilized from donors' peripheral blood.Median time to white blood cell engraftment was 13 (9-27) days.Median time to platelet engraftment was 14 (10-28) days.Mixed chimerism after transplantation developed in 4 patients and no patient presented graft failure.Eight patients developed grade Ⅱ to Ⅲ acute graft-versus-host disease (GVHD),while as chronic GVHD occurred in 9 patients.Among 12 patients with EB virus (EBV) reactivation,2 patients developed post-transplant lymphoproliferative disorder (PTLD),7 were suspected as PTLD and 3 were considered as relapse of primary disease.With a median follow-up of 20 months (range:0.5-108 months) after transplantation,the estimated 2-year overall survival (OS) rate was (60.0 ± 11.0) ％ in all patients.During the follow-up,12 patients survived,8 died including 5 within 100 days after HSCT.Among 5 non-remission patients before HSCT,4 patients died within 100 days after HCT.Conclusions HID HSCT is an effective treatment for adult patients with HLH to achieve remission and long-term survival.High proportion of mixed chimerism has been seen at early stage after transplantation.EBV reactivation and early transplant-related mortality are common.
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Objective To evaluate the value of three-dimensional ultrasound volume contrast imaging (VCI) and tomo graphy ultrasound imaging (TUI) techniques in observing fetal spinal conus medullaris (CM) position and lumbar enlargement of spinal cord morphologic changes,for assessment of tethered cord (TC).Methods Totally 17 abnormal fetuses of spinal diseases combined with TC (abnormal group) were examined by three dimensional ultrasound VCI and TUI techniques.The position of CM was recorded,and the transverse and anteroposterior diameters of lumbar enlargement of spinal cord were measured and compared with 300 cases of normal fetuses (normal group).Results As the growth of the gestational age (CA),CM terminal position increased.All the ends of CM located at L3 or L3 above level in normal.The transverse and anteroposterior diameters of lumbar enlargement in normal group showed good linear relationship with GA.Transverse diameter (mm) =0.677+0.147 ×GA (R2 =0.836,P＜0.05),anteroposterior diameter (mm)-0.994+ 0.152× GA (R2=0.894,P＜0.05).Compared with the corresponding GA fetuses in normal group,the anteroposterior diameter of lumbar enlargement decreased in abnormal group (P=0.002),while no statistical difference of the transverse diameter was found between the two groups (P=0.082).Conclusion Position of CM and lumbar enlargement measure ment can provide valuable reference information for clinical prenatal diagnosis of fetal spinal TC.
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Objective To evaluate clinical efficacy and survival outcomes of neoadjuvant treatment on early stage bulky cervical carcinoma.Methods A total of 155 cases with bulky stage Ⅰ b2 or Ⅱ a2 cervical carcinoma in Affiliated Tumor Hospital of Shantou University Medical College from Nov.2010 to Feb.2015 was reviewed and divided into two groups according to pre-operative treatment 108 cases in the neoadjuvant treatment group and 47 cases in the control group who underwent radical surgery directly.The clinical,pathologic,and follow-up data were analyzed retrospectively.Results The total response rate of neoadjuvant treatment was 75.0％.Histological grade in neoadjuvant treatment group was better than the other group and the rate of deep myometrial infiltration was tend to low in neoadjuvant treatment group.There was no difference in pathological type,parametrial involvement,lymph node metastasis,and lymph vascular space invasion between two groups.The rate of postoperative treatment was similar (92.6％ vs 87.2％,P ＞ 0.05).The overall survival rate of neoadjuvant treatment group was 96.4％ and the other group was 88.9％ (P =0.069).Conclusions Neoadjuvant treatment was effective for early stage bulky cervical carcinoma.It might reduce tumor histological grade and maybe improve the overall survival of patients.
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Epstein-Barr virus (EBV)infection is highly prevalent in general population,serum EBV antibody can be detected in about 90% of the adults.Forty years of researches have demonstrated that EBV infection is closely related to a variety of hematological diseases,such as infectious mononucleosis, EBV-related lymphoproliferative disorders,lymphoma and hemophagocytic syndrome.This paper reviews EBV-associated hematological diseases and its pathogenic mechanism.
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Objective To explore the clinical effect and toxicity of daunorubicin combined with cytarabine (DA regimen) and idarubicin combined with cytarabine (IA regimen) for the treatment of patients with acute myeloid leukemia (AML) as induction chemotherapy. Methods The clinical data of 84 newly diagnosed AML patients (except M3) treated with DA or IA regimen were analyzed retrospectively. DA regimen group included 32 patients (17 males and 15 females with median age of 46 years), while IA regimen group included 52 patients (29 males and 23 females with media age of 49 years). Efficacy index was complete remission (CR), total efficiency and adverse reactions after one course of chemotherapy rate. Results In DA regimen group,the CR rate was 65.6 %(21/32), and the total efficiency rate was 75.0 %(24/32), while in IA regimen group, the CR rate was 71.2 %(31/52), and the total efficiency rate was 80.8 %(42/52), respectively, but, the differences of media survival and 5-year survival rate were not statistically significant (16.8 months vs. 24.9 months, 26 % vs. 44 %, both P>0.05). The main side effect in the two groups included hematologic (bone marrow suppression) and non-hematologic adverse reactions, with no significant difference between the two groups (all P>0.05). Conclusion For newly diagnosed AML patients, remission rate and total efficiency of DA regimen are same as IA regimen after one course treatment, and adverse events between the two regimens do not differ significantly.
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Objective To explore the clinical efficacy and safety of low-dose decitabine combined with cytarabine for myelodysplastic syndromes (MDS). Methods Clinical data of 15 patients with MDS who took the therapeutic regimen with decitabine combined with cytarabine were collected from January 2012 to January 2015. The clinical efficacy and adverse effects were assessed. Results Among the 15 patients, 4 cases were complete remission (CR), 5 cases were partial remission (PR) and 6 cases were stable disease (SD) and progressive disease (PD). The total effective rate was 60.0 % (9/15). Grade Ⅲ-Ⅳ bone marrow depression occurred in 11 cases with incidence rate of 73.3 % (11/15), and the total incidence rate of infection was 40.0 % (6/15), including lung infection of 26.7 % (4/15). All the infections were controlled after active supportive treatment and anti-infection therapy. No patient died of chemotherapy. Conclusions Low-dose decitabine combined with cytarabine can effectively treat MDS and delay the progress of disease. The patients can tolerate the adverse effects in chemotherapy with a low mortality rate.
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Objective To investigate the efficacy of rituximab-containing regimen in Epstein-Barr virus associated hemophagocytic lymphohistiocytosis (EBV-HLH). Methods A retrospective analysis involving 6 EBV-HLH patients who had received treatment with rituximab-containing regimen was performed. The patients who were diagnosed with lymphoma or primary HLH subsequently were not included in the analysis. Results All patients were males. The median age was 27.5 years (range 20-61 years). Two patients received rituximab-containing regimen as primary therapy, and got partial remission (PR) within 2 weeks after the first course of rituximab, but relapsed within 4 weeks. Four patients received rituximab-containing regimen as salvage therapy, but none achieved remission. The 6 patients died due to HLH and complications, such as infection and hemorrhage. Laboratory data including white blood cell count, haemoglobin concentration, platelet count ferritin, alanine transaminase, aspartate transaminase,total bilirubin, fibrinogen and EBV-DNA did not show statistical significance (all P>0.05). Conclusion The efficacy of rituximab as a treatment for EBV-HLH is not as good as that in the previous study, and a prospective clinical trial of rituximab-based monotherapy is needed to answer the question.
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Objective: To evaluate the efficacy and safety of tirofiban infusion to infarct related vessels on patients with ST segment elevation myocardial infarction (STEMI) during emergency percutaneous coronary intervention (PCI). Methods: From Jan 2013 to Jun 2014, a total of 30 STEMI patients were enrolled as tirofiban group (tirofiban 500μg was infused to infarct related vessels during emergency PCI), and received intravenous drip of tirofiban 0.1 μg•kg-1•min-1 for 24h after stent implantation; another 31 STEMI patients were regarded as pure stenting group during the same period and they received direct stent implantation during emergency PCI. Computer-assisted Quantitative Blush Evaluator (QuBE) score, left ventricular ejection fraction (LVEF) during hospitalization and after six-month follow-up and incidence rate of major adverse cardiovascular events were compared and analyzed between two groups. Results: There were no significant difference in baseline data between two groups, P>0.05. Compared with pure stenting group, after six months, there were significant rise in QuBE score [(10.88±5.03) scores vs. (14.70±6.69) scores] and LVEF [(57.19±4.59)% vs. (59.80±5.34)%], and significant reduction in incidence rate of MACE (35.5% vs. 10.0%) in tirofiban group, P<0.05 all. Conclusion: Tirofiban application in infarct related vessels during emergency PCI in STEMI patients can effectively and safely improve myocardial microcirculation perfusion level and it is worth extending.
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Objective To explore the prognostic factors of endometrial carcinoma.Methods 166 patients with endometrial carcinoma in Cancer Hospital of Shantou University Medical College from May 1996 to June 2009 were analyzed retrospectively.Prognostic factors were analyzed by univariate analysis.Results The total 5-year survival rate of 166 cases was 86.7 ％.The univariate analysis showed that the age,deep myometrial invasion,lymph-node metastasis and operative-pathological staging were significantly associated with the prognosis (P ＜ 0.05).As well as,according to muhivariate Cox proportional-hazard model,3 independent factors as the age,deep myometrial invasion and lymph-node metastasis were related significantly to overall survival (P ＜ 0.05).Conclusions The 5-year survival rate of endometrial carcinoma is high.The age,deep myometrial invasion and lymph-node metastasis are independent prognostic factors of endometrial carcinoma.
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Objective To analyze the clinical characteristics,treatment and prognosis of primary lymphoma of bone (PLB).Methods Retrospective analysis of 9 cases with newly diagnosed PLB was performed.The primary lesion was located in bone and no evidence of lesion was found in other tissues.All the lesions were confirmed by histological examination and immunohistochemical staining.The clinical manifestation and radiological appearance of all cases were non-specific.Results 9 patients were enrolled in the current study including 6 males and 3 females with average age of 34 years old (15-71 years old).All cases had suffered local pain or edema as initial symptom.Single bone infiltration was detected in 7 patients,while multiple bones infiltration was noticed in 2 patients.The lesion distribution was as follows:4 lesions were situated in pelvis (3 in ilium and 1 in sacral),1 in femur,1 in humerus,1 in scapula,and 2 in spine.2 cases were treated with radiotherapy and chemotherapy,3 cases were treated with chemotherapy and hematopoietic stem cell transplantation,1 case was treated with chemotherapy and surgery,and 3 cases received chemotherapy alone.With in a median follow-up of 8 months,6 patients showed overall response (including 5 cases of complete response and 1 case of partial response).Conclusions PLB is a rare condition,and the diagnostic criteria and treatment are still not well defined.Early diagnosis and prompt treatment usually achieves satisfactory prognosis.The possibility of PLB must be concerned for patients with bone pain,soft tissue swelling or unexplained fractures,and pathological examination should be carried on as soon as possible.
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<p><b>OBJECTIVE</b>To analyze the clinical manifestations, laboratory data, therapy, and prognosis in patients with hemophagocytic lymphohistiocytosis (HLH).</p><p><b>METHODS</b>A retrospective study was carried out in 192 adult patients with HLH between 2003 and 2013.</p><p><b>RESULTS</b>Of the 192 cases, 70 cases were secondary to cancer and 64 cases secondary to infection. According to HLH-2004 criteria, the coincidence rate of indices were: fever (98.96%), high level of serum ferritin (94.27%), increased level of soluble interleukin- 2 receptor(sCD25) (94.79%), decreased or absent activity of NK cells (94.27%), cytopenias (80.73%), splenomegaly (80.21%), emophagocytosis in bone marrow, spleen or lymph nodes (74.48%), hypofibrinogenemia (50.52%), hypertriglyceridemia (37.50%). In addition, 94.27% of patients were presented with liver dysfunction, 96.35% with infections, and 75.52% with coagulopathy. Incidences of central nervous system symptoms and rash were 19.27% and 20.31%, respectively. Among cancer, infection and rheumatic group, there were statistically differences on white blood cells (WBC), platelet (PLT), sCD25, alanine aminotransferase, aspartate aminotransferase, total bilirubin and globulin(GLO) (P<0.05). The differences of WBC, PLT, albumin (ALB), GLO, brain natriuretic peptide, creatinine, urea nitrogen between survival group and death group had statistical significance.</p><p><b>CONCLUSION</b>The secondary HLH occurs from various underlined diseases. Cancer, especially T- cell lymphoma, is the main cause, Secondly, it is EB virus infection. The diagnostic sensitive indicators are Persistent fever, higher level of serum ferritin, low or absent NK-cell activity, and increased sCD25 were the most valuable parameters for diagnosis. Cytopenias were not common in early phase of HLH secondary to rheumatic diseases. WBC, PLT, ALB, GLO could be used as the preliminary parameters for diagnosis. Cardiac insufficiency, renal insufficiency and coagulation dysfunction play important roles in prognosis.</p>