Analysis of the Prognostic Value and Risk Factors of Early Relapse for Newly Diagnosed Multiple Myeloma Patients in the Era of Novel Agents / 中国实验血液学杂志

OBJECTIVE@#To investigate the influece of early relapse in the era of novel drugs on the prognosis of the patients with newly diagnosed multiple myeloma（NDMM） and risk factors, and to provide the basis for the early identification of the high-risk patients and guiding the treatment.@*METHODS@#The clinical data of the patients with NDMM admitted to our hospital from November 2011 to May 2022 were retrospectively analyzed. According to whether the progression free survival（PFS） was more than 12 months, they were divided into early relapse group（≤12 months） and late relapse group（＞12 months）. The high-risk factors of the patients in two groups were analyzed, including age, anemia, renal insufficiency, hypercalcemia, increasing of lactate dehydrogenase（LDH） level, Extramedullary disease (EMD), International Staging System（ISS） stage, Revised International Staging System （R-ISS） stage, cytogenetic abnormalities(CA) detected by fluorescence in situ hybridization（FISH）, and treatment efficacy. The meaningful clinical indicators were screened, and multivariate analysis was used to explore the high-risk factors of early relapse.@*RESULTS@#170 patients with NDMM were collected, including 25 cases in early relapse group and 145 cases in late relapse group. The median OS time of the patients in early death group was 20 months, and 140 months in late relapse group by the end of follow-up, there was significant difference in OS of the patients between two groups（P<0.001）. Fifteen patients（56.0％）in early relapse group obtained ≥VGPR, and 113（77.9%） patients in late relapse group, the difference was statistically significant（P=0.011）. Survival outcomes remained poor among early relapse patients irrespective of depth of response to initial therapy. Multivariate analysis showed that the EMD and high-risk CA predicted early relapse.@*CONCLUSION@#The prognosis of patients with early relapse in NDMM is poor. EMD and high-risk CA is an independent prognostic factor of early relapse.

Analysis on Clinical Characteristics and Prognosis of 47 Patients with Extranodal NK/T Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical features and prognostic factors of patients with extranodal NK/T cell lymphoma (ENKTL).@*METHODS@#The clinical data of patients with ENKTL from November 2009 to November 2019 was collected and retrospectively analyzed to clarify the clinical features of ENKTL, and evaluate the factors that affected survival and prognosis.@*RESULTS@#Forty-seven patients with ENKTL were collected, median age was 40 (12-82) years old, and more common in males than females, at the ratio of 1.47∶ 1. The median follow-up was 28 (1-112) months, and 5-year overall survival (OS) rate was 49.3%. The 5-year OS rates of the subjects with ECOG performance stage 0-1 and ≥2 were 51.6% and 0 (P=0.001), respectively. The 5-year OS rates of International Prognostic Index (IPI) score 0-1 and ≥2 were 60.0% and 40.6% (P=0.027), respectively. The 5-year OS rates of Ann Arbor staging Ⅰ/Ⅱ and stage Ⅲ/Ⅳ were 61.3% and 31.7% (P=0.005), respectively. The 5-year OS rates of the patients with presentation of B symptoms and without presentation of B symptoms were 79.0% and 30.1% (P=0.013), respectively. The 5-year OS rates of plasma EBV-DNA level < 5×10@*CONCLUSION@#ECOG score, B symptoms, the copy number of EBV-DNA, and treatment regimens are independent prognostic factors for OS of patients with ENKTL.

Clinical Characteristics and Prognosis Affecting-Factors of the Patients with Burkitt Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical characteristics and treatment outcome of patients with Burkitt lymphoma.@*METHODS@#The clinical data of 27 patients with Burkitt Lymphoma were collected and retrospectively analyzed, the clinical characteristics, laboratory data, survival and the factors affecting the prognosis were also analyzed.@*RESULTS@#Among the 27 patients (mainly for adults), the median age was 30 (15-83) years old, the ratio of male and female was 3.5∶1. There was no EB virus infection in all the patients, 92.6% of the patients showed extranodal organs involvement, 40.7% of them were leukemic stage, 85.2% patients belonged to Ⅲ and Ⅳ stage, 74.1% patients belonged to high/high-middle risk according to IPI index. In the terms of molecular biology, five patients were treated with next-generation sequencing test, and the MYC gene mutations were detected out in alt the patients, and the most common mutations were CCND3, ID3 and TP53. The overall response rate (ORR) for all the patients was 85.2%, the complete response (CR) rate was 63.0%, and the partial response rate was 22.2%, the 5-year progression-free survival rate and overall survival rate of the patients was 76.6% and 76.6%, respectively, which showed that the efficacy of the patients in high-dose methotrexate treatment group was higher than that in the non-high high-dose methotrexate treatment group. For the patients treated with LMB89 chemotherapy, the CR was 78.6%, ORR was 100%, the 5-year survival rate was 92.9%, which was superior to the patients treated with other regimens. Auto-hematopoietic stem cell transplantation as consolidation treatment could improve the prognosis for those patients who could not tolerate high-dose chemotherapy. Univariate analysis showed that ECOG score, the level of LDH>500 U/L, WBC level, CNS involvement, short-term effect and LMB89 regimen were the risk factors affecting the prognosis of the patients.@*CONCLUSION@#The adult Burkitt lymphoma are highly aggressive. For the patients in high-dose methotrexate treatment group, especially LMB89 regimen can improve the survival of the patients, and to choose HSCT as a consolidation treatment can be a choice for those patients who could not tolerate high-dose chemotherapy.

Clinical Characteristics and Prognosis of Acute Myeloid Leukemia with FLT3-ITD Mutation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics of acute myeloid leukemia(AML) patients with FLT3-ITD(Fms-like tyrosine kinase3, intenal tandem duplication) mutation and their response to treatment.</p><p><b>METHODS</b>Retrospective analysis of 128 newly diagnosed AML (except type M3) patients was performed between January 2014 and July 2017. Patients were divided into FLT3-ITD mutated group and non-mutated group. Mutation detection was carried out by using polymerase chain reaction(PCR) and gene sequencing analysis. Standard 3 + 7 or CAG regimen were taken as the first induction chemotherapy, 4 cases received sorafenib, overall survival (OS) was calculated by Kaplan-Meier.</p><p><b>RESULTS</b>Ninety-seven patients can be evaluable for clinical data available; 4 patients were FLT3-TKD mutated, which accounted for 4.1%; 19 patients were FLT3-ITD mutated, which accounted for 19.59%(19/97). Median white blood cell count (WBC), percentage of peripheral blasts and LDH value were significantly higher in FLT3-ITD group than those in non-mutated group [64.65(1.07-587.92)×10/L vs 39.68 (0.45-203.81) ×10/L](P<0.01), [69.62(16-99)% vs 36.35(0-92) %](P<0.01 ) and [LDH 526(124-2 729)U/L vs 265(20-1977)U/L](P<0.05), respectively. The frequency of coexisting NPM1 mutation was higher in FLT3-ITD group than that in non-mutated group [36.8(7/19)% vs 6.8 (5/74) %](P<0.01). The CR+PR was lower in FLT3-ITD group than that in non-mutated group [31.6(6/19)% vs 64.9 (48/74)%](P<0.05). OS in FLT3-ITD group was significantly shorter than that in non-mutated group (5 vs 18 months)(P<0.05). There is no significant difference in OS between FLT3-ITD concomitant with and without NPM1 mutation groups(5 vs 5 months)(P>0.05). The median OS was 13 months for the FLT3-ITD patients taking sorafenib.</p><p><b>CONCLUSION</b>The FLT3-ITD is a common mutation in AML, FLT3-ITD mutated AML is more likely concomitant with NPM1 mutation with higher number of WBC, percentage of peripheral blasts and LDH value, thus CR is low after the 1st treatment and survival is poor.</p>

Application of functional near-infrared spectroscopy in schizophrenia / 上海交通大学学报（医学版）

Functional near-infrared spectroscopy (fNIRS) is a relatively new technique that can measure the hemoglobin changes in brain tissue. Depending on the absorption for different wavelength, relative changes in the concentration of hemoglobin in brain can be measured, obtaining the hemodynamic characteristics of brain to understand the brain functional state in real-time. Compared with other neuroimaging techniques, it has some advantages and has been used in psychiatry rapidly. Schizophrenia is one of the most common mental disorders, researches on its pathogenesis have focused on collection of structural and functional alteration in brain. Existing techniques can provide only indirect evidence, while fNIRS can perform brain function monitoring in real-time. A number of studies have suggested that fNIRS signal could be used as a biomarker for schizophrenia identification and adjuvant diagnosis. This paper reviewed the research progress in the application of fNIRS in schizophrenia.

Effect of social cognition and interactive training on rehabilitation of schizophrenic patients in community / 上海交通大学学报（医学版）

Objective·To explore the effectiveness and feasibility of social cognitive and interactive training (SCIT) in rehabilitation of schizophrenic patients, and propose to establish a new mode of community rehabilitation. Methods·A total of 60 patients with schizophrenia managed in the community in Shanghai Hongkou District were divided into control group and intervention group with 30 cases in each group. The control group was treated with conventional community management. The intervention group accepted SCIT courses at the base of conventional community management. Before and after the intervention, all patients completed the related scales for schizophrenia. Scale scores were analyzed with analysis of variance by SPSS 22.0 to explore the rehabilitation effect of training. Results·In intervention group, the time used in the face emotion identification task (FEIT) had no significant difference with the control group, but the correct rate for FEIT increased significantly. In intervention group, ambiguous intentions hostility questionnaire-ambiguous items (AIHQ-A) scores were significantly lower. The total and sub scale scores of positive and negative syndrome scale (PANSS) and scale for assessment of negative symptoms (SANS), Calgary depression scale for schizophrenia (CDSS) scores were significantly decreased in intervention group. Otherwise, Toronto alexithymia scale (TAS) scores also decreased. Personal and social performance scale (PSP) scores in the SCIT group were increased after training. Finally, according to the training participation and the feedback of the patients, the training had a higher degree of acceptance and positive affirmation. Conclusion·SCIT can improve the social cognition and social function of schizophrenic patients in the community, also improve the mental symptoms, especially the negative symptoms and depressive symptoms, and has high feasibility and acceptability, so it can be promoted in community-based rehabilitation.

Research Progress of Cell Immunotherapy in Treatment of Hematological Malignancies-Review / 中国实验血液学杂志

Cell immunotherapy, as an important mean of tumor therapy, infuses a large number of immune effector cells amplified in vitro to the patients, resulting in the anti-tumor effect. There have been a series techniques of cell immunotherapy, including T lymphocyte therapy, dendritic cell-based immune cell therapy, natural killer cell therapy, gamma delta T cell therapy and so on. The preparation and culture conditions, anti-tumor mechanism, target cells etc of these immune cells are not the same, the each with its advantages and disadvantages. Many clinical studies have showed that the patients with a variety of tumors including hematological malignancies, who adopted cell immuno-therapy, had the prolonged survival, an improved quality of life, and with the less adverse reactions. This review summarizes the available data on the characteristics of different cell immunotherapies and their application in hematological malignancies.

Correlation Between Brain Activation Changes and Cognitive Improvement Following Cognitive Remediation Therapy in Schizophrenia: An Activation Likelihood Estimation Meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Several studies using functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) have indicated that cognitive remediation therapy (CRT) might improve cognitive function by changing brain activations in patients with schizophrenia. However, the results were not consistent in these changed brain areas in different studies. The present activation likelihood estimation (ALE) meta-analysis was conducted to investigate whether cognitive function change was accompanied by the brain activation changes, and where the main areas most related to these changes were in schizophrenia patients after CRT. Analyses of whole-brain studies and whole-brain + region of interest (ROI) studies were compared to explore the effect of the different methodologies on the results.</p><p><b>METHODS</b>A computerized systematic search was conducted to collect fMRI and PET studies on brain activation changes in schizophrenia patients from pre- to post-CRT. Nine studies using fMRI techniques were included in the meta-analysis. Ginger ALE 2.3.1 was used to perform meta-analysis across these imaging studies.</p><p><b>RESULTS</b>The main areas with increased brain activation were in frontal and parietal lobe, including left medial frontal gyrus, left inferior frontal gyrus, right middle frontal gyrus, right postcentral gyrus, and inferior parietal lobule in patients after CRT, yet no decreased brain activation was found. Although similar increased activation brain areas were identified in ALE with or without ROI studies, analysis including ROI studies had a higher ALE value.</p><p><b>CONCLUSIONS</b>The current findings suggest that CRT might improve the cognition of schizophrenia patients by increasing activations of the frontal and parietal lobe. In addition, it might provide more evidence to confirm results by including ROI studies in ALE meta-analysis.</p>

Analysis of Clinical Feature and Curative Efficacy of 30 Patients with T Cell Lymphoblastic Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyze clinical feature and curative efficacy of patients with T cell lymphoblastic lymphoma(T-LBL).</p><p><b>METHODS</b>The clinical data including clinical features, laboratorial results, survival and prognostic factors from 30 patients with T-LBL were retrospectively analyzed.</p><p><b>RESULTS</b>Median age of 30 cases was 24.5 years, 25 (83.3%) patients were at high-intermediate and high risk by IPI, extranodal disease was present in 73.3% of the patients, 17(56.7%) patients had bone marrow involvement and 19(63.3%) had mediastinal masses. The overall response rate(ORR) for the whole group was 80.0%, the complete response rate was 36.7%, the 3-5-year overall survival rate was 37.1% and 26.0%, respectively. Compared with NHL-like regimens, ALL-like chemotherapy could improve the survival of patients, the 3-year overall survival rate was 59.1% vs 27.3%. For adult patients, the median overall survival time was 35 months vs 13 months in HSCT group and chemotherapy group, there was a statistically significant difference(P=0.019). ECOG score, IPI score, anemia, the level of LDH and β2-MG, therapy regimens, the short-term efficacy and the level of fibrinogen were the related factors for prognosis.</p><p><b>CONCLUSION</b>T-LBL is more common in young men, with large mediastinal mass and bone marrow involvement. ALL-like chemotherapy regimens are superior to NHL-like regimens, HSCT can improve the survival and reduce the recurrence of adult patients. Chemotherapy combined with allogeneic DC/CIK immune cell treatment can be used in relapsed patients.</p>

Detection of Molecular Cytogenetic Aberrations by Fluorescence in Situ Hybridization in Different Bone Marrow Samples of Multiple Myeloma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To detect the molecular cytogenetic abnormalities in different bone marrow samples of multiple myeloma by using fluorescence in situ hybridization (FISH) technology. The bone marrow cells from 48 cases of MM were taken for sorting the plasma cells using CD138 magnetic beads, and the biopsy tissue from 10 cases of MM was taken and embedded in parafin, then the 2 kinds of samples were detected by using FISH. D13s319/RB1, 1q21/P53, IgH, IgH/FGFR3, IgH/MAF probes were detected in 58 patients with new diagnosed multiple myeloma (MM) by FISH technology.</p><p><b>RESULTS</b>Fluorescent signals were both seen in 2 different types of bone marrow samples and cytogenetic aberrations were detected in 30/58 (51.7%) patients, 29.3% (17 out of 58) cases had both D13S319 and RB1 deletion. The positive rates of P53 deletion, 1q21 amplification and IgH rearrangement were 12%, 27.6% and 20.7%, respectively. Only 7 cases (23.3%) had one cytogenetic abnormality, other 23 (76.7%) cases all had 2 to 5 kinds of different abnormalities.</p><p><b>CONCLUSION</b>More than half of MM patients have cytogenetic change, and most of them are complex chromosomal abnormality. The different kinds of samples can expand the useful extension of FISH technology and acquire more cytogenetic information for clinician.</p>

Clinical analysis of 13 patients with primary bone lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyse the clinical featuers, prognositic factors and treatment outcomes of primary bone lymphoma(PBL).</p><p><b>METHODS</b>The clinical data of 13 patients with PBL in our hospital from 2005 to 2014 were analysed retrospectively.</p><p><b>RESULTS</b>The median age of these patients was 40 (25-71) years old, ostealgia was the initial symptom(100%). The main histologic type was diffuse large B cell lymphoma (DLBCL) (11/13, 84.6%), and among other 2 cases 1 case was anaplastic large cell lymphoma(ALCL) and other 1 case was B lymphoblastic lymphoma. All 13 cases were treated with chemotherapy, 6 cases got complete remission(46.2%) and 7 cases got partial remission(53.8%). There was no statistical relation of age, sex, stage, β2-MG level, LDH level, pathological type and the application of rituximab with the complete remission rate (P>0.05). After the median follow up of 12 (3-72) months, 3 cases died of diease progression and 6 cases maintained in complete remission, the median progression-free survival was 13 (2-72) months.</p><p><b>CONCLUSION</b>The most common histologic type is DLBCL, its main treatment method is the combined chemical therapy, but the role of rituximab in treatment is not clear, thus larger clinical trial is necessary.</p>

Clinical characteristics and therapeutic efficacy of immunoglobin D multiple myeloma / 中国实验血液学杂志

This study was aimed to evaluate the clinical characteristics of immunoglobin D multiple myeloma (IgD MM) and its curative efficacy. The clinical data of 15 cases of newly diagnosed IgD MM from April 1993 to June 2013 were analyzed retrospectively. Among 15 cases received induction treatment, the traditional chemotherapy was carried out in 9 cases, bortezomib-based therapy was performed in 6 cases. The diagnostic criteria and disease response criteria of MM were based on International Myeloma Working Group (IMWG) criteria,survival time was analyzed by using Kaplan-Meier method, the median age of patients was 57 years (range 40-72), the ratio of male to female was 2:1, the MM patients in Durie-Salmon stage III accounted for 100% (15/15) , the MM patients with λ light chain accounts for 80% (12/15) , with bone lesion 86.7% (13/15), with pleural effusion 26.7% (4/15) , with renal impairment (RI) 86.7% (13/15) ,with anemia 93.3% (14/15) , with serum album<35 g/L 26.7% (4/15). The median creatinine clearance rate (Ccr) of patients was 23.1 (6-44) ml/min, and median hemoglobin level was 82 (43-131) g/L. The results showed that in followed-up 11 cases, 8 cases died, 3 cases survived; the average duration of follow-up for these cases was 20 (0.5-138) months, the median progression-free survival time (PFS) was 7 (95%CI4.6-9.4) months, and the median overall survival (OS) time was 15 (95%CI6.6-27.4 ) months. Compared traditional chemotherapy with bortezomib regimen therapy,median OS time was 17 (95%CI6.1-28.0) months vs 15 (95%CI 0.0-33.3) months (P = 0.90) . Assessable curative effect of 14 cases was as follows: CR 33.3% (5/15); VGPR 13.3% (2/15); PR 20% (3/15); SD 20% (3/15); PD 6.7% (1/15). It is concluded that IgD MM is a rare type of MM and has a poor prognosis. Bortezomib may be beneficial for some patients with extramedullary infiltration. Autologous hematopoietic stem cell transplantation may improve survival time.

Clinical characteristics and prognostic factors of 62 cases with Hodgkin lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics, pathologic types and prognostic factors of Hodgkin lymphoma (HL).</p><p><b>METHODS</b>Retrospective analyses of clinical data of 62 HL patients, including 45 from Peking University third hospital and 17 from Shanxi Dayi hospital.</p><p><b>RESULTS</b>Sixty-two HL patients accounted for 5.66% of the total newly diagnosed patients with lymphoma (45/795) in the period with a ratio of male:female as 2.1:1. All the pathological types were classical Hodgkin lymphoma (cHL), including 33 cases (53.2%) of nodular sclerosis type (NS) and 19 cases (30.6%) of mixed cell type (MC). Of the 56 cases followed up, the total responsive rate was 92.9% , and 2- , 3- and 5- year overall survival (OS) rates were 97.7%, 92.2% and 80.5% respectively with the median OS as 45 (8-184) months. Analyses of the prognostic factors indicated that the involvement of spleen(P=0.042)and German Hodgkin Study Group(GHSG) risk score (P=0.002) were poor factors with statistic significance.</p><p><b>CONCLUSION</b>HL is one of the curable malignant tumors, 5-year OS rate was 80.5% in this group. After recurrence, part of patients developed slowly and could be salvaged with second-line therapy with high remission rate. GHSG scoring system and involvement of spleen could predict the prognosis in HL setting.</p>

Analysis of clinical features and prognostic factors in 59 cases of follicular lymphoma / 中国实验血液学杂志

This study was aimed to explore the clinical features and related prognostic factors of follicular lymphoma (FL). The total of 59 newly diagnosed FL patients were analyzed retrospectively in term of age, sex, clinical manifestation, laboratory data, pathological examination, clinical stage and so on, so as to find out the related prognostic factors. The results showed that the median age of the 59 patients was 55 years, among them the male-female ratio was 1: 1.36. Among the 64.4% cases with the involvement outside lymphonode , the bone marrow involvement accounted for 28.8%, while the involvement of gastrointestinal tract and skeleton was in the second place. The rate of BCL-2/JH gene rearrangement was 30.3%, III-IV of clinical stage accounted for 71.2% in these FL patients. During the follow up of the 56 patients, OR and CR rates were 96.4% and 80.3% respectively, 5 year-and 10 year overall survival rates were 88.2% and 74.1% respectively, the relapse rate was 33.9%. Univariate analysis showed that the age, the longest diameter of involved node, gastrointestinal involvement, serum lactate dehydrogenase, ECOG, IPI, aaIPI, FLIPI, FLIPI2 and whether initial therapy could achieve CR or not were influencing factors of prognosis for FL patients. Multivariant analysis showed that the gastrointestinal involvement, IPI, aaIPI and whether initial therapy could achieve CR or not were independent prognostic factors for OS. The relative mortality risk of patients without CR was 70 times of patient with CR. It is concluded that the newly diagnosed FL is more observed in middle to old aged females, displaying frequent bone marrow involvement, less frequent BCL-2/JH gene rearrangement, III-IV of clinical staging, and high relapse rate, but longer survival time. The gastrointestinal involvement, IPI, aaIPI and whether CR can be achieved or not after initial therapy are independent prognostic factors for FL patients.

Clinical observation and long-time follow-up of patients with malignant lymphoma treated with autologous peripheral blood hematopoietic stem cell transplantation / 中国实验血液学杂志

This study was purposed to evaluate the efficacy of autologous peripheral blood hematopoietic stem cell transplantation (auto-PBHSCT) for patients with malignant lymphoma. From January 1992 to June 2012, 32 malignant lymphoma (ML) patients were treated with auto-PBHSCT in our hospital. There were 56 cases of non-Hodgkins lymphoma (NHL) and 16 cases of Hodgkin's lymphoma(HD). The preconditioning regimens of total body irradiation (TBI) plus cyclophosphamide combined with etoposide/pharmorubicin were used in 50 patients, and the BEAM (BCNU+etoposide+Ara-C+melphalan) were used in the other 22 patients. The average number of CD34(+) cells was (6.6 ± 4.9) ×10(6)/kg. The results showed that transplanted cells were engrafted and hematopoiesis was reconstituted in all patients. The median time of neutrophilic granulocyte recovery up to ≥ 0.5×10(9)/L was 12 ± 4.4 days, and the platelet recovery up to ≥ 20×10(9)/L was 14 ± 4.9 days . The transplantation related mortality was 4.2%. The patients were followed up for 6-217 months. The median follow-up time was 63.5 months. 1-year OS rate was 92.3 ± 3.2%. 3-years OS rate was 81.4 ± 4.9%. 5-years OS rate was 77.6 ± 5.3%. 10-years OS rate was 68.9 ± 6.8%. It is concluded that auto-PBHSCT is effective for malignant lymphoma, and long time follow-up shows that the OS rate is still high. Furthermore, the safety of auto-PBHSCT can also be received. Before transplantation the patients with CR can get higher OS rate.

The masseter inhibitory reflex and the recovery of the reflex after magnetic stimulation in normal subjects / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the masseter inhibitory reflex (MIR) and the recovery cycle of the MIR reflex after magnetic stimulation in normal subjects.</p><p><b>METHODS</b>In 30 healthy subjects we studied the MIR evoked by single magnetic stimulation in the mental territory. Masseter electromyographic activity, latency and duration of the early silent periods (SP1) and late silent periods (SP2), and SP2 amplitude percent were recorded. Paired stimuli technique was used, conditioning and test stimuli were delivered at different interstimulus intervals (ISI), ie.100, 200, 300, 400, 500, and 600 ms, then the recovery cycle of the MIR was analyzed.</p><p><b>RESULTS</b>Latency of SP1 was 12.1 (11.1, 14.4) ms, and duration of the SP1 was (17.3 ± 2.9) ms. Latency of SP2 was (47.7 ± 6.0) ms, and duration of the SP2 was (39.7 ± 13.3) ms. SP2 amplitude percent was 100.0%. With the paired stimuli technique, SP1 of the inhibitory reflex evoked by the test stimuli was found to be stable at every ISIs, but SP2 of the inhibitory reflex evoked by the test stimuli, instead, varied according to different ISI. With the short ISI, the area of SP2 evoked by the test stimuli was reduced, and with the increase of the ISI, the recovery degree of the area of SP2 evoked by the test stimuli was ascending, at 100 ms the SP2 amplitude percent was 17.1%, at 400 ms it was 93.4%, and it was close to 100% at 600 ms.</p><p><b>CONCLUSIONS</b>The study indicates that the use of the MIR elicited by the single and paired magnetic stimulation may be useful to examine or quantify some craniofacial diseases.</p>

Analysis of clinical characteristics and prognostic factors of 110 cases with primary gastrointestinal tract non-Hodgkin's lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the pathologic types, prognostic factors and effective treatment of PGI-NHL.</p><p><b>METHODS</b>Clinical data of 110 PGI-NHL patients were analyzed retrospectively, and so did prognostic factors and each treatment outcome.</p><p><b>RESULTS</b>Of the 110 patients, the male-female ratio was 1.56:1 with a median age of 58.5 years. Stomach was the most common site and small intestine was the second. The main histological subtypes were diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) NHL. Among the 75 patients followed up, the 5-year overall survival (OS) rate was 62%, the median survival time was 36 months. Univariate analysis showed a similar prognosis between PG-NHL and primary bowel NHL (P > 0.05), and PGI-MALT had better prognosis than PGI-DLBCL. Among PGI-DLBCL, the ratio of germinal center (GC) sub-type to non-GC was 1:2.82. Among three main treatments, chemotherapy combined with surgery had the lowest mortality rate, compared with each alone. Disease progress mortality was 51.7% of overall mortality.</p><p><b>CONCLUSION</b>The percent of non-GC in PGI-DLBCL is higher than that of in non PGI-NHL. The 5-year OS rate is lower than the 5-year OS rate of DLBCL. Combined chemotherapy is the first line treatment. Surgery is important in the control of the complications of GI tract. Maintenance treatment is important even in those who had systemic treatments.</p>

Clinical features of 16 cases of lymphoplasmacytic lymphoma/Waldenström macroglobulinemia / 中国实验血液学杂志

In order to investigate the clinical manifestations, diagnosis, therapy and prognosis of lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM), 16 patients with LPL/WM were analyzed retrospectively. The results showed that the average age of 16 patients with LPL/WM was 65.1 years old, the most common syndromes were anemia and hyperviscosity syndrome, bone marrows were composed of small lymphocyte, admixed with variable numbers of plasma cells and plasmacytoid lymphocytes. And lymph node biopsy revealed that most cells expressed B-cell-associated antigen. Among the 16 cases, complete remission was 25%, overall response rate (ORR) was 81.3%, overall survival time was 6 to 108 months. 3 patients died and survival rate was 81.3 %. It is concluded that the clinical course of LPL/WM is typically indolent. These patients can acquire remission in clinic, but can not be cured, some of them can transform into patients with more malignant lymphoma.

N400 elicited by incongruent ending words of Chinese idioms in healthy adults / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Prior research about N400 has been mainly based on English stimuli, while the cognitive processing of Chinese characters is still unclear. The aim of the present study was to further investigate the semantic processing of Chinese idioms.</p><p><b>METHODS</b>Event related potentials (ERP) component N400 was elicited by 38 pairs of matching (congruent) and mismatching (incongruent) ended Chinese idioms: ending words with same phoneme but different shape and meaning (sPdSdM), with similar shape but different phoneme and meaning (sSdPdM), with same meaning but different phoneme and shape (sMdPdS), and words with different phoneme, shape and meaning (dPdSdM) and recorded by Guangzhou Runjie WJ-1 ERP instruments. In 62 right-handed healthy adults (age 19 - 50 years), N400 amplitudes and latencies were compared between matching and mismatching conditions at Fz, Cz and Pz.</p><p><b>RESULTS</b>N400 showed a midline distribution and could be elicited in electrodes Fz, Cz and Pz. The mean values of N400 latencies and amplitudes were obtained for matching and mismatching ending words in healthy adults. Significant differences were found in N400 latencies and amplitudes in matching and mismatching ending-words idioms in healthy adults (P < 0.05). Compared with matching ending-words idioms, N400 latencies were prolonged and the amplitudes were increased in mismatching ones. N400s elicited by different types of stimuli showed different latencies and amplitudes, and longest N400 latency and largest N400 amplitude were elicited by ending-words with dPdSdM. No gender difference was found of N400 latency and amplitude in this study (P > 0.05).</p><p><b>CONCLUSIONS</b>Compared with English stimuli, Chinese ideographic words could provide more flexible stimuli for N400 research in that the words have 3-dimension changes - phoneme, shape and meaning. Features of N400 elicited by matching and mismatching ending words in Chinese idioms are mainly determined by the meaning of the word. Some issues of N400 elicited by Chinese characters deserve further research.</p>

Changes of pathogens for nosocomial infection of patients with hematological diseases / 中国实验血液学杂志

In order to investigate the distribution of nosocomial infection in patients with hematological diseases in our hospital, and to explore the changes of the pathogens isolated. The method of retrospective investigation and analysis was employed. 1164 strain pathogens were isolated from the patients with hematological diseases during the period of 1997-2009. The results showed that the Gram-positive cocci infection increased gradually during the 13 years, but has been stable in the last 4 years. The Gram-negative bacteria showed a trend decrease. The fungi increased during these years. The rates of infection with gram-positive cocci, gram-negative bacteria and fungus were 28.2%, 59.8% and 12.0% respectively. For the details, Escherichia coli infection rate was the highest: 12.1%, followed by Pseudomonas aeruginosa (9.1%), Enterobacter (8.4%), Klebsiella pneumoniae (7.4%), Staphylococcus epidermidis (6.3%) and Enterococci (6.6%). The distribution of G(+)- and G⁻ pathogens showed obvious change on end of 1990's and beginning of this century, but it was tending towards stability on recent years; the incidence of fungus was tending towards increase, which was related to wide application of strong broad-spectrum antibiotics. In conclusion, the patients with hematological diseases, as the high-risk group of nosocomial infection, should be monitored strictly. Infection is related to many factors, and the main factor is dysfunction of autoimmunity. The strategies should be explored to strengthen the immune protection and set up a reasonable scheme of antibiotics.