Misdiagnosis as diffuse large B-cell lymphoma: clinicopathological analyses of 431 patients / 肿瘤研究与临床

Objective To analyze the cases that are easily misdiagnosed as diffuse large B-cell lymphoma (DLBCL),and to explore the diagnosis,differential diagnosis and clinicopathological features of DLBCL.Methods The clinicopathological data of 431 cases preliminarily diagnosed as DLBCL in the Department of Pathology,School of Basic Medical Science,Peking University from October 2016 to December 2017 were retrospectively analyzed.Further immunohistochemical staining and molecular biological tests were performed if necessary.Results The diagnostic accuracy rate of DLBCL was 88.86％ (383/431).Misdiagnosis mainly occurred in follicular lymphoma (36 cases,8.35％),high-grade B-cell lymphoma (HGBL) with gene rearrangement of c-myc and bcl-2 or bcl-6 (4 cases,0.93％),atypical lymphoid tissue hyperplasia (3 cases,0.70％),mantle cell lymphoma (3 cases,0.70％),classic Hodgkin lymphoma (CHL) (1 case,0.23％) and composite lymphoma (DLBCL and CHL) (1 case,0.23％).Except the poor quality of sections,the lack of immunohistochemical markers,the poor knowledge of the diagnosis of DLBCL and high-grade FL as well as HGBL were the main reasons of misdiagnosis.Conclusions The diagnosis and differential diagnosis of DLBCL is based on morphology,and it needs to combine with the corresponding immunohistological markers and molecular biological detection when necessary.The recognition of clinical and pathological features of various types of misdiagnosed lymphomas should be strengthened.

Study on the relationship between protein expression and gene abnormalities of myc, bcl-2 and bcl-6in diffuse large B-cell lymphoma / 白血病·淋巴瘤

Objective To study the frequency of diffuse large B-cell lymphoma (DLBCL) with multi-genetic alteration, and its correlation with c-myc, bcl-2 and bcl-6 protein expression. Methods 50 cases diagnosed with DLBCL from January 2012 to December 2016 were collected. The expression of c-myc, bcl-2 and bcl-6 was analyzed by immunohistochemistry. Interphase fluorescence in situ hybridization (I-FISH) analysis was performed to identify the genetic alteration of c-myc, bcl-2 and bcl-6. Results In all cases, there were 27 males and 23 females with a median age of 50 years (range: 3-85 years). 23 (46.00 %) cases were defined as primary nodal DLBCL and 27 (54.00 %) cases were primary extra-nodal DLBCL, with gastrointestinal tract (48.15 %, 13/27) being the most common site of involvement. c-myc protein expression was detected in 94.00 % (47/50) cases, in which 82.00 % (41/47) cases exhibited high levels of c-myc expression with positive nuclear staining observed in over 40.00 % of tumor cells. The positive rate of bcl-2 protein was 84.00 % (42/50), 76 % (38/50) cases presented with high-level bcl-2 expression. Concurrent high expression of c-myc and bcl-2 were presented in 18 cases (36.00%). FISH analysis demonstrated c-myc gene rearrangement in 7 cases (14.00 %) and amplification in 2 cases (4.00 %). bcl-2 gene rearrangement was detected in 6 cases (12.00 %) and 4 cases (8.00 %) exhibited gene amplification. bcl-6 gene rearrangement was identified in 8 cases (16.00%), amplification in 3 cases (6.00%), and 1 case concomitantly harbored the rearrangement and amplification of bcl-6. Multi-genetic alterations were defined in 4 cases with 3 cases fulfilling the criteria for double-hit lymphoma (DHL) and 1 case for triple-hit lymphoma (THL). For the cases with concomitant high-level expression of c-myc and bcl-2 proteins, 3 cases (16.67 %) was detected with multi-genetic alterations, including 2 cases for DHL and 1 case for THL. Conclusions The proportion of DLBCL with multi-genetic alterations is 8.00 % in this study. The genetic alterations are not consistently correlated with the protein expression. The molecular genetic testing is reliable for the identification of DHL.

A comparison of the forces applied to a manikin during laryngoscopy with anesthesiological nurses and seniority anesthesiologists use laryngoscopes / 中国实用护理杂志

Objective To observe and compare the different forces between doctors and nurses used visible laryngoscope endotracheal intubation applied to the oropharyngeal organization. Methods 10 nurses (to carry on laryngoscope intubation theory, and had certain study period practice) were chosen in group A and 10 clinical anaesthetize doctors (to be possible correctly used visible laryngoscopes) were chosen in group B, two groups used the visible laryngoscope on the same model person body inserted the tube, computer monitor software recorded results. Results The impulse force was (25.57±3.37) N·s and insert tube time was (25.3±3.3) s in group A which were higher than (16.47±2.99) N·s and (16.2±3.0) s in group B (t=2.550 and 2.207, P0.05). Conclusions There is no statistics difference forces applied to the oropharyngeal organization between nurses and anaesthesiologists using visible laryngoscope intubation, and visible laryngoscope intubation technique is easy to learn and it is feasible by the nurse to master the technology and applied to anesthesia intubation care and emergency care.

Analysis of clinicopathological features of 21 patients with enteropathy-associated T-cell lymphoma / 肿瘤研究与临床

Objective To investigate the clinicopathological and prognosis features of enteropathy-associated T-cell lymphoma (EATL).Methods 21 cases of EATL,6 cases of peripheral T-cell lymphoma (PTCL) and 11 cases of natural-killer/T-cell lymphoma (NKTCL) were collected from January 2008 to May 2015.The immunophenotype of the tumor cell was tested by EnVision and as well as EBV-EBER for EB virus.Some patients were performed with follow-up data.Results 21 EATL patients included 14 males,7 females and the middle age was 55 years old (40-79 years old).15 patients affected the small bowel,4 cases affected colon,2 cases affected more than one site.18 cases were mono-morpholohic EATL while 3 cases were classical EATL.The expression rates of neoplastic cells for CD3ε,CD4,CD8,CD56,Granzyme B,TIA-1 were 95.24 ％ (20/21),20.00 ％ (3/15),73.68 ％ (14/19),85.71％ (18/21),64.71％ (11/17),88.89 ％ (16/18) respectively.The expression of EBER in EATL patients (0,0/21) was obviously lower than that in NKTCL patients (100 ％,11/11).17 EATL patients had follow-up data,and the middle survival time was 15 months.No different prognosis was found in the three kinds of T-NHL (P =0.697).Conclusions EATL usually occurs in elder male and jejunum.The diagnosis of EATL needs a lot of information,including clinical history,endoscopy,histomorphology,immunophenotype and EBV-EBER result.EATL has low mobidity and high malignancy,it still lacks impactful therapeutic regimen.

Evaluation of electromyogram activity and masticatory efficiency in edentulous individuals whose maxillomandibular horizontal relationship records were obtained with three different methods / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study was performed to investigate the electromyographic (EMG) activity of the masseter muscle and the anterior temporalis muscle, as well as the masticatory efficiency after insertion of the dentures in edentulous individuals whose maxillomandibular horizontal relationship records were obtained with three different methods.</p><p><b>METHODS</b>Ten edentulous individuals were enrolled in this study. Three types of complete dentures for these 10 edentulous patients were made according to their different maxillomandibular horizontal relationship records. The maxillomandibular horizontal relationship of complete dentures was recorded by three methods. In the first method (A), the maxillomandibular horizontal relationship was determined at the gothic arch tracing apex. In the second method (B), the relationship was 1 mm anterior to the tracing apex with the gothic arch. In the last method (C), the horizontal jaw relation was recorded by natural chewing. The muscular activities of the three complete dentures were examined by EMG. The masticatory efficiency was evaluated based on the absorbance. The differences among the dentures were statistically analyzed with SPSS 17.0.</p><p><b>RESULTS</b>The muscular activities of dentures B and C were much higher than that of denture A during clenching in the center occlusion and during chewing (P<0.05). The highest asymmetry index was found indenture C, which was significantly higher than those of dentures A and B (P<0.05). A statistically significant increase in the absorbance was observed between dentures B and C (P<0.05); otherwise, no statistically significant differences were observed (P>0.05) between B and C.</p><p><b>CONCLUSIONS</b>Given the limitations of this experimental design, in edentulous individuals the maxillomandibular horizontal relationship recorded at 1 mm anterior to the tracing apex with the gothic arch can improve the function of masticatory muscles and strengthen masticatory performance.</p>

Influence of different designs and porcelain/glaze firing on the marginal and internal fit of implant-supported zirconia crowns / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study investigated the influence of different designs and porcelain/glaze firing on the marginal and internal fit of three kinds of computer aided design/computer aided manufacturing (CAD/CAM) zirconia ceramic implant-supported crowns.</p><p><b>METHODS</b>Three groups of zirconia ceramic implant-supported crowns with different designs were produced from copings by using a Cercon CAD/CAM system (n = 8). The first two groups comprised double-layer crowns (zirconia coping + veneer) with regular (Group A) and full circumferential zirconia-collar marginal designs (Group B). The third group was composed of anatomic single-layer zirconia crowns without cores (Group C). Initially, the marginal and internal gaps of the copings and crowns were individually replicated by light-body silicon and then measured by micro-computed tomography scanning before and after porcelain/glaze firing. Five measurements were employed: vertical marginal gap (MG); horizontal marginal discrepancy (HMD); chamfer area (CA); axial wall (AW); and axial-occlusal transition area (AOT). Statistical analyses were performed by SPSS 17.0.</p><p><b>RESULTS</b>HMD measurements in Group A were statistically higher than those in Groups B and C (P < 0.05), regardless of whether the values were obtained before or after porcelain/glaze firing. By contrast, the HIMD measurements in Groups B and C showed no significant difference (P > 0.05). Moreover, no differences were noted in MG, CA, AW, and AOT among the three groups (P > 0.05). All the measurements in the three groups showed no significant change after porcelain/glaze firing (P > 0.05), except for MG in Group A, which significantly decreased (P < 0.05).</p><p><b>CONCLUSION</b>The marginal fits of the double-layer crowns with full circumferential zirconia-collar and the anatomic single-layer zirconia crowns were superior to that of the double-layer crowns with regular margins. The MG of the crowns with regular margins was obviously influenced by porcelain firing.</p>

Influence of coping material selection and porcelain firing on marginal and internal fit of computer-aided design/computer- aided manufacturing of zirconia and titanium ceramic implant-supported crowns / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aimed to investigate the influence of coping material and porcelain firing on the marginal and internal fit of computer-aided design/computer-aided manufacturing (CAD/CAM) of zirconia ceramic implant- and titanium ceramic implant-supported crowns.</p><p><b>METHODS</b>Zirconia ceramic implant (group A, n = 8) and titanium metal ceramic implant-supported crowns (group B, n = 8) were produced from copings using the CAD/CAM system. The marginal and internal gaps of the copings and crowns were measured by using a light-body silicone replica technique combined with micro-computed tomography scanning to obtain a three-dimensional image. Marginal gap (MG), horizontal marginal discrepancy (HMD), and axial wall (AW) were measured. Statistical analyses were performed using SPSS 17.0.</p><p><b>RESULTS</b>Prior to porcelain firing, the measurements for MG, HMD, and AW of copings in group A were significantly larger than those in group B (P < 0.05). After porcelain firing, the measurements for MG of crowns in group A were smaller than those in group B (P < 0.05), whereas HMD and AW showed no significant difference between the two groups (P > 0.05). Porcelain firing significantly reduced MG (P < 0.05) in group A but significantly increased MG, HMD, and AW in group B (P < 0.05) HMD and AW were not influenced by porcelain firing in group A (P > 0.05).</p><p><b>CONCLUSION</b>The marginal fits of CAD/CAM zirconia ceramic implant-supported crowns were superior to those of CAD/CAM titanium ceramic-supported crowns. The fits of both the CAD/CAM zirconia ceramic implant- and titanium ceramic implant-supported crowns were obviously influenced by porcelain firing.</p>

Expression of microRNA-191 in T lymphoblastic leukemia/lymphoma and its underlying mechanism / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the correlation between MicroRNA-191 (miR-191) and T lymphoblastic leukemia/lymphoma (T-ALL/LBL) to probe its underlying molecular mechanism.</p><p><b>METHODS</b>The expression of miR-191 was examined by real-time PCR (RT-PCR) in 20 T-ALL/LBL tissue samples and 20 lymphoid reactive hyperplasia (LRH) tissue samples. The correlation between miR-191 and the clinicopathological feature of T-ALL/LBL was analyzed. Antisense miR-191 lentiviral vectors was constructed and transfected into T-ALL/LBL Jukat cells. After transfection, the expression of miR-191 was examined by RT-PCR. The cell activity was evaluated by CCK-8 asssy. The cell cycle and apoptosis were determined by flow cytometry.</p><p><b>RESULTS</b>Compared with LRH samples, the results of RT-PCR showed significant upregulation of miR-191 in 20 T-ALL/LBL tissue samples (1.875±0.079 vs 1.000, P<0.05). The expression level of miR-191 was negatively associated with prognosis. Compared with LV-NC-GFP and control groups, the expression of miR-191 significantly decreased after transfection of antisense miR-191 lentiviral vectors (0.578±0.012 vs 1.011±0.053 and 1.000, P<0.05), the percentages of apoptotic cells and the cell in G0/G1 phase significantly increased (P<0.05).</p><p><b>CONCLUSIONS</b>miR-191 might play a significant role in the development of T-ALL/LBL, implicating a new target for therapy.</p>

Characteristics and prognosis of EBV-positive gastric diffuse large B-cell lymphoma / 中国肿瘤临床

Objective:To investigate pathological characteristics and prognosis of patients with Epstein-Barr virus (EBV) positive gastric diffuse large B-cell lymphoma (DLBCL). Methods:Through retrospective study, we collected 75 cases of patients with DLBCL that oc-curs in the stomach. The patients were divided into two groups consisting of 60 cases of EBV negative control group and 15 cases of EBV positive group. To analyze the pathological characteristics and prognosis of patients with EBV positive gastric DLBCL, immunohisto-chemical and Epstein-Barr encoding region (EBER) in situ hybridization methods were used to detect Bcl-2, c-myc protein expression, and EBV-encoded RNA (EBER). Results:In certain aspects of clinical manifestations, such as age, gender, and origin, the comparison be-tween EBV-positive and EBV-negative groups had no statistically significant difference. The same results were obtained for Bcl-2 and c-myc protein expression. However, a statistically significant difference (P=0.01) was observed under the R-CHOP regimen where the me-dian overall survival (OS) of the EBV-positive and EBV-negative groups were 15.1 and 31.4 months, respectively. Conclusion:In pa-tients with DLBCL of the stomach, the EBV infection had no obvious effects in terms of clinical manifestation, origin, morphology, and protein expression of tumor cells. EBV-positive DLBCL was not limited to elderly patients. Under the R-CHOP regimen, the prognosis of EBV-positive patients was worse than that of EBV-negative patients.

Effect of auxiliary resistance forms on the resistance and marginal fitness of complete crowns for short molar preparations / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of different auxiliary resistance forms on the resistance and marginal fitness of complete crowns for short molar preparations.</p><p><b>METHODS</b>A total of 70 Nissin resin teeth were prepared with 20° total occlusal convergence, 2.5 mm of occlusocervical height, and a shallow finish line on a milling machine. The milled preparations were then randomly assigned to 7 groups of 10. The first group was used as the control group. A total of 30 dies were modified by preparing interproximal grooves with angles of 0°, 6°, and 20° centered on the mesial and distal surfaces of the dies. The rest of the teeth were prepared with occlusal holes in the center of the occlusal surface milled with the same burs to form 0°, 6°, and 20° holes. Cobalt-chromium copings were fabricated for all specimens. The marginal gap of specific points on the axial surface was measured before and after cementation. The resistance of each specimen was evaluated by applying an external force at an angle of 45° to the long axis of the die by using a universal testing machine in a lingual to buccal direction. The maximum force applied before crown dislodgement was measured. Data were analyzed using the SAS 9.2 software.</p><p><b>RESULTS</b>The results showed that the 0° groove, 0° hole, and 6° hole were effective in improving the resistance of the complete crowns (P<0.05). The 0° groove, 6° groove, 0° hole, 6° hole, and 20° hole had significant difference with the control group in terms of marginal discrepancies (P<0.05).</p><p><b>CONCLUSION</b>Auxiliary resistance forms with less degree indicate greater resistance force but worse marginal fitness. In clinical practice, if the resistance of a preparation is enough, the auxiliary resistance forms should be avoided from being used.</p>

Testicular lymphoma: a clinicopathological study of 65 cases / 中华血液学杂志

<p><b>OBJECTIVE</b>To summarize the clinicopathological features of testicular lymphomas (TL).</p><p><b>METHODS</b>The medical records of 65 patients diagnosed with TL between 2008.1.1 and 2014.11.30 were retrospectively reviewed.</p><p><b>RESULTS</b>TL was classified as primary (PTL) when there's no prior diagnosis of an extara-testicular lymphoma/leukemia and no concurrent widespread disease, except for the concomitant involvement of ipsilateral inguinal lymph nodes; otherwise it was classified as secondary (STL). Of our patients group, 46 (70.8%) cases were classified primary TL as and the other 19 (29.2%） cases were secondary TL. All patients presented with painless testicular swelling. The median age of STL was significantly younger than that of PTL [65 (12-88) ys vs 13 (1-75) ys, P<0.001]. Additionally, a striking difference in the distribution of histological subtypes was observed between the PTL and STL patients group.</p><p><b>CONCLUSION</b>Primary TLs were more common than secondary. Striking differences in the distribution of patients'age and histology were found between STL and PTL.</p>

Expression and prognostic value of COX- 2, p16(INK4A) and p53 in patients with classical Hodgkin lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the expression level of COX-2, p16(INK4A) and p53 in patients with classic Hodgkin's lymphoma (cHL), and to evaluate their correlation with prognosis.</p><p><b>METHODS</b>The clinical data and samples of 52 cHL cases were collected. Immunohistochemical staining was performed to analyze the proteins level mentioned above and in situ hybridization of EBV encoded RNA (EBER) to clarify the tumor EBV infection state. Correlation between the protein expression and prognosis of patients was analyzed.</p><p><b>RESULTS</b>Of 52 cases, the male and female ratio was 1.6∶1, the age was from 22 to 68 years old. All lesions located primarily in lymph nodes. All samples from 52 cases were stained with COX-2, p16(INK4A) and p53, and the positive expression of COX-2 was found in 28 cases (53.8%）, that of p16(INK4A) in 25 cases (48.1%)and p53 in 42 cases (80.8%）. All patients were divided into two groups according to differences in age (<40 years/ ≥ 40 years), gender (male/female), EBV infection (yes/no), B symptoms (yes/no), and the Ann Arbor staging (Ⅰ-Ⅱ/Ⅲ-Ⅳ), the correlation with COX-2, p16(INK4A) and p53 expression were analyzed, and only p53 expression was correlated with Ann Arbor staging (P=0.027). The statistical analysis of correlations between COX- 2, p16(INK4A) and p53 showed that the expression of COX-2 was strongly correlated with p53 (P=0.008), and p16 (INK4A) was not related to either COX-2 or p53 (P=0.246 and 0.958). Kaplan- Meier univariate OS analysis using SPSS17.0 software showed that only COX-2 expression was an adverse prognostic factor for patients'event free survival (EFS) (P=0.003). Meanwhile COX-2 expression was a unique independent prognostic factor analyzed by COX proportional hazards regression model (HR=0.091, 95% CI 0.017-0.505, P=0.006).</p><p><b>CONCLUSION</b>The expression rate of COX-2, p16 (INK4A) and p53 in the cHL were relatively high; and they were not statistically correlated with tumor EBV infection status; the COX-2 positive group had poor prognosis, but only event free survival time becomes statistically significant shorter. COX proportional hazard regression model was used to analyze the COX-2 expression as a independent adverse prognostic factors for EFS.</p>

Analysis of different endodontic sealers and strategies of root canal irrigation on the bond strength of fiber posts / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the influence of eugenol-containing and resin-containing endodontic sealers on the bond strength of fiber posts using different strategies of root canal irrigation.</p><p><b>METHODS</b>Forty-eight mandibular premolars were endodontically treated. The specimens were randomly assigned into two groups according to different endodontic sealers. Group A used Endofil (eugenol-containing endodontic sealer), and group B used AH-plus (resin-containing endodontic sealer). After post space preparation, each group was randomly assigned into three subgroups according to the strategies of root canal irrigation (eight premolars in each subgroup). Group Al and B1: 0.9%NaCl irrigation; Group A2 and B2: 17% ethylene diamine tetraacetic acid (EDTA)+5.25%NaClO+0.9%NaCl irrigation; Group A3 and B3: ultrasonic agitation associated with 1 7%EDTA+5.25%NaClO+0.9%NaCl. One week after the cementation of fiber posts using RelyX™ Unicem, a push-out test was performed to measure the bond strength of the posts. The microstructure of the root canal surface was examined under scanning electron microscope (SEM).</p><p><b>RESULTS</b>The bond strengths of the six groups were as follows: Al (7.96±2.23) MPa, A2 (9.95±2.89) MPa, A3 (18.88±3.69) MPa, B1 (11.41±3.71) MPa, B2 (14.00±4.04) MPa, and B3 (19.14±3.27) MPa. Statistical analysis revealed a significant interaction between the different endodontic sealers and the strategies of root canal irrigation (P<0.05). Lower bond strength was found in group Al but not in group BI (P<0.05), and the same result was revealed when comparing group A2 and B2. No significant difference was observed between group A3 and B3 (P>0.05). SEM showed that the root canal in group A3 and B3 achieved the cleanest surface with nearly all dentine tubules opened.</p><p><b>CONCLUSION</b>The eugenol-containing endodontic sealer can impair the bond strength of fiber posts compared with the resin-containing sealer when the root canal is irrigated by 0.9% NaCl or 17%EDTA+5.25%NaClO+0.9%NaC. No difference was observed between the two sealers when using 17%EDTA+5.25% NaCIO+0.9%NaCl combined with ultrasonic irrigation.</p>

Retrospective analysis of EB virus infection in patients with angioimmunoblastic T-cell lymphoma and its clinical significance / 白血病·淋巴瘤

Objective To investigate the EB virus (EBV) infection and its clinical significance in angioimmunoblastic T-cell lymphoma(AITCL).Methods 62 patients diagnosed as AITCL between 2008 Jan and 2011 Dec were retrospective analyzed.All cases were re-confirmed and classified with the histology and immunology according to 2008 WHO Classification.In situ hybridization of EBV encoded RNA (EBV-EBER) was performed.Clinical characteristics and follow-up data of patients were collected.Results 42 ％ (26/62) AITCL cases were EBER-positive.EBV infection was found to be significant correlation with age over 60 years and poor response to therapy (P =0.025,P =0.049,respectively).However,EBV infection had no relationship with the overall survival,the presence of B symptom and the Ann Arbor stage.Conclusion In AITCL,EBV infection seems not to be associated with the overall survival,B symptom and Ann Arbor stage,but it may have impacts on theraputic response.

Analysis of clinical pathological characteristics and prognosis of elderly patients with EB virus-positive diffuse large B-cell lymphoma / 白血病·淋巴瘤

Objective To analyze the clinical pathological characteristics and prognosis of elderly patients with EB virus-positive diffuse large B-cell lymphoma (EBV+ DLBCL).Methods 24 elderly patients with EBV + DLBCL were collected to evaluate their clinical pathological characteristics and prognosis by comparison with the EBV-DLBCL,NOS during the same period.Results 24 EBV + DLBCL cases demonstrated two morphologic subtypes:polymorphic and monomorphic.And polymorphic subtype showed geographic necrosis more frequently than that in monomorphic subtype.According to Hans and Choi models,the majority of EBV+ DLBCL of the elderly were classified as non-GCB subtype (91.3 ％ and 100.0 ％,respectively).55.0 ％ cases showed CD30 positive,which was significantly higher than that in EBV-DLBCL group (P ＜ 0.001).Under the treatment of R-CHOP regimen,the overall survival (OS) of the elderly EBV+ DLBCL patients showed no significant difference with the ＞50-year old EBV-DLBCL patients (the median OS were 44.2 months and 29.2 months,P =0.587).Conclusions The elderly EBV + DLBCL patients are normally presented with polymorphic and monomorphic patterns.And geographic necrosis are often seen in polymorphic cases.CD30 expression and non-GCB subtypes are high.With the R-CHOP regimen,the OS of the elderly EBV+ DLBCL patients is similar with that of ＞50-year old EBV-DLBCL patients.

Clinicopathologic features and prognosis of primary bone anaplastic large cell lymphoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features, differential diagnosis and prognosis of primary bone anaplastic large cell lymphoma(ALCL).</p><p><b>METHODS</b>Twelve patients diagnosed with primary bone ALCL were retrospectively reviewed. The clinicopathologic features, immunohistochemic findings and results of in situ hybridization for EB virus were analyzed.</p><p><b>RESULTS</b>Of the 12 patients, the male-to-female was 7: 5 with a median age of 17.5 years (range from 9 to 64 years). Bone pain was the presenting symptom in all patients. Radiographic examination demonstrated solitary osteolytic lesion in 8 patients and multiple lesions in the rest 4 patients. Spine (7 cases) was the most common site to be involved, followed by ilium (5 cases), sacrum (2 cases), humerus (1 case) and collarbone (1 case). Ten patients were available with the follow-up data including 5 ALK-positive and 5 ALK-negative patients, and the follow-up time was 2 to 47 months. Interestingly, the 3 dead patients were ALK-negative whereas 5 of 7 ALK-positive patients achieved remission.</p><p><b>CONCLUSIONS</b>Primary bone ALCL is a rare type of non-Hodgkin lymphoma and it more frequently involves the axial skeleton. Boys and young males are more commonly affected. Patients usually present at an early stage and have a relatively favorable prognosis. Expression of ALK protein may be associated with a favorable prognosis in primary bone ALCL.</p>

Clinicopathological analysis of 273 cases of primary intestinal non-Hodgkin's lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To study the clinicopathological characteristics and prognostic factors in Chinese patients with primary intestinal non-Hodgkin's lymphomas (PINHL).</p><p><b>METHODS</b>The clinical symptoms, pathological features, diagnostic and prognostic factors of 273 cases diagnosed with PINHL from our center were analyzed.</p><p><b>RESULTS</b>Among 273 cases, 189 were male and 84 female, the male to female ratio was 2.3:1. The age of patients ranged from 2 to 85 years old with the median age of 46. The most frequent site of the lesions was ileocecus (n=83, 30.4%). The clinical symptoms of PINHL were unspecific with abdominal mass frequently seen in B-cell lymphoma, and perforation, hypogastric pain and "B" symptoms more common in T-cell lymphoma. Endoscopic biopsy diagnosis rate was 90.3%. Of 273 cases, B-cell lymphoma (n=232, 85.0%) dominated PINHL with the most common subtype of diffuse large B-cell lymphoma-not otherwise specified (DLBCL-NOS) (n=132, 48.4%), while the T-cell lymphoma (n=41, 15.0%) were much less seen with the most common subtype of enteropathy-associated T-cell lymphoma (EATL) (n=15, 36.6%). There were 245 cases were followed up, including 206 cases of B-cell lymphoma and 39 cases of T-cell lymphoma, it was found that the prognosis of B-cell lymphoma is much better than that of T-cell lymphoma (P<0.05). Operation had no significant effect for the overall survival rate. But for patients with aggressive lymphoma, operation can improve the survival rate.</p><p><b>CONCLUSION</b>It indicates that PINHL often occurs as B cell type, DLBCL-NOS is the most common histological type. Ileocecus is the most common site involved and enteroscope biopsy is a good method of diagnosis. Compared with T-cell lymphoma, B-cell lymphoma has different clinical manifestations and a better prognosis. Patients with aggressive lymphoma can benefit from operation.</p>

Factorial analysis of root canal irrigants and cements on coronal microleakage after cementing metal post-cores / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of different root canal irrigants and cements on coronal microleakage and the interaction effects after cementing metal post-cores.</p><p><b>METHODS</b>Ninety newly extracted single-rooted mandibular human premolars were endodontically treated. Post spaces were prepared in the root canals, and Co-Cr post-cores were cast routinely. The specimens were randomly divided into six groups (n = 15) via a two-way factorial design method. The irrigant factors (A) included A1: no irrigant (75% alcohol wiping), A2: 3% H2O2 + 0.9% NaCl, and A3: 15% ethylenediamine tetraacetic acid (EDTA) + 5.25% NaClO. The cement factors (B) included B1: zinc polycarboxylate cement, and B2: glass ionomer cement. The specimens received treatments based on the grouping of A1B1, A1B2, A2B1, A2B2, A3B1, and A3B2. All samples were sectioned longitudinally after being immersed in India ink for three weeks. The microleakages were observed using a stereomicroscope. The SPSS 13.0 software package was used for factorial analysis.</p><p><b>RESULTS</b>The mean microleakage scores and standard deviations were as follows: Group A1BI: (1,192.59 +/- 417.84) microm, Group A1B2: (1,317.38 +/- 527.35) microm, Group A2B1: (1,429.33 +/- 482.68) microm, Group A2B2: (1,026.79 +/- 459.49) microm, Group A3B1: (1,448.29 +/- 561.02) microm, and Group A3B2: (1,922.47 +/- 678.86) microm. The A2B2 group showed minimum microleakage, whereas the A3B2 group showed maximum microleakage. The microleakage degrees among different irrigants presented significant statistical difference (P < 0.05), but the two cements showed no significant difference (P > 0.05). An interactive effect on the microleakage existed between the irrigants and the cements after cementing the metal post-cores (P < 0.05).</p><p><b>CONCLUSION</b>When cementing metal post-cores, the coronal microleakage following 3% H2O2 + 0.9% NaCl irrigation combined with glass ionomer cement can be reduced. The combined application of 15% EDTA + 5.25% NaClO and glass ionomer cement significantly aggravates microleakage.</p>

Three-dimensional finite element analysis of the effect of the location and diameter of implants on the stress distribution in three-unit implant-supported posterior cantilever fixed partial dentures under dynamic loads / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To examine the effect of the location and diameter of implants on stress distribution in three-unit implant-supported posterior cantilever fixed partial dentures (FPD) in the mandible.</p><p><b>METHODS</b>A three-dimensional finite element model was developed to represent a rigid implant-supported posterior FPD that restores the second left premolar, first molar, and second molar. The location of the distal implant with a diameter of 4.8 mm remained the same, whereas the mesial implants with diameters of 4.1 and 4.8 mm were successively moved toward the posterior area with distances of 5.5, 8.0, 10.5, and 13.0 mm from the long axis of the mesial implants to the first premolar to form the cantilever FPD. Dynamic loads of 250 N were applied from different directions on the buccal and lingual cusps of the FPD to simulate the masticatory cycle for 0.875 s. The maximum Von Mises stresses were calculated using the finite element analysis software MSC. Marc and Partran.</p><p><b>RESULTS</b>The maximum Von Mises stresses of the mesial and distal implants increased to some extent as the mesial implants moved toward the posterior area. Significant increases in the maximum Von Mises stresses were obtained when the mesial implants were located more than 8.0 mm posterior to the first premolar, and moderate increases in the stresses were observed when the mesial implants were located less than 8.0 mm posterior to the first premolar. The use of a broader implant reduced the stress on the interface between the bone and the implants. The maximum Von Mises stresses were found in the cervical region of the cortical bone adjacent to the mesial or the distal implants during stages II to IV of the masticatory cycle. Off-axial loading induced more stresses compared with vertical loading.</p><p><b>CONCLUSION</b>The location of implants in three-unit implant-supported posterior cantilever FPD is a significant factor that influences the stress generated in the interface between the bone and the implants. An implant-supported cantilever FPD is a feasible option for restoring missing teeth when the length of the cantilever is not greater than the width of a premolar. Two important factors should be considered before choosing the implant diameter, namely, bone volume and cantilever length.</p>

Study of clinicopathologic features of primary mediastinal B-cell lymphoma / 白血病·淋巴瘤

Objective To elucidate clinical pathological features of primary mediastinal B-cell lymphoma (PMBL) and its difference compared with diffuse large B-cell lymphoma,not otherwise specified (DLBCL,NOS).Methods The clinical histories and pathological datas of 24 PMBL cases and 31 cases of DLBCL,NOS as the control group were collected.Immunohistochemical staining and a follow-up study was conducted.Results The distribution of gender showed significant difference when the age of onset of PMBL patients was obviously younger with the medial age of 30 years old (P ＜ 0.001).All cases presented as a huge mass in mediastinal site with compression symptoms.PMBL was similar to DLBCL in the morphology of tumor cells but fibrosis of various degrees was common,more than 70.8 ％ (17/24) cases had the collagen bundles split.CD23 positive rate (40.0 ％,6/15) in PMBL was significantly higher than the control group (3.2 ％,1/31)(P =0.003).Conclusion PMBL frequently occurs in young female people,mostly happens in mediastinal site and adjacent area,but rarely has distant dissemination.PMBL has the characteristics of various degrees of collagen fiber hyperplasia,and CD23 positive could be used to differentiate PMBL from DLBCL,NOS.