Primary adrenal NK/T cell lymphoma: a clinicopathologic analysis of six cases / 中华病理学杂志

Objective: To investigate the clinicopathologic features of primary adrenal NK/T cell lymphoma (PANKL). Methods: Six cases of PANKL were collected at Henan Provincial People's Hospital from January 2000 to December 2021. The clinicopathologic features including morphology, immunophenotype, treatment and prognosis were retrospectively analyzed, and relevant literature was reviewed. Results: There were two males and four females. The median age was 63 years (ranged from 57 to 68 years). The tumors involved bilateral adrenal glands in 4 cases and unilateral adrenal gland in 2 cases. The main clinical symptom was low back pain without obvious cause. Serum lactate dehydrogenase (LDH) is elevated in five cases. The imaging feature was rapidly enlarging mass initially confined to unilateral/bilateral adrenal glands. Morphologically, the lymphoid cells were mainly medium-sized with a diffuse growth pattern. Coagulative necrosis and nuclear fragmentation were common. Angioinvasion was seen. Immunophenotypically, the neoplastic cells were positive for CD3, CD56 and TIA-1 while CD5 was negative in 5 cases. All cases were positive for EBER by in situ hybridization with more than 80% proliferative activity by Ki-67. Four cases received chemotherapy, one case underwent surgery, and one case underwent surgery with chemotherapy. Follow-up was done in 5 cases; one case was lost to follow-up. Three patients died with a median survival of 11.6 months (3-42 months). Conclusions: PANKL is rare with highly aggressive clinical presentation and poor prognosis. Accurate diagnosis entails correlation of histomorphology, immunohistochemistry, EBER in situ hybridization and clinical history.

Clinicopathological features of mature T/NK cell lymphoma with aberrant CD20 or CD79α expression / 中华病理学杂志

Objective: To investigate the clinicopathological characteristics and prognosis of mature T/NK cell lymphomas with aberrant CD20 or CD79α expression. Methods: A retrospective analysis of 641 cases of mature T/NK cell lymphoma diagnosed from January 2014 to December 2020 was performed, and 14 cases of CD20-positive and one case of CD79α-positive mature T/NK-cell lymphoma were identified. Histological examination, immunohistochemical characterization, in situ hybridization for Epstein-Barr virus encoded early RNA (EBER), and PCR testing for immunoglobulin and T cell receptor (TCR) gene rearrangements were performed. Clinicopathological characteristics of these lymphomas were analyzed. Results: There were 13 males and 2 females, with a median age of 56 years. There were 8 cases of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), 3 cases of extranodal NK/T-cell lymphoma, nasal type (ENKTCL), 2 cases of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) and 2 cases of angioimmunoblastic T-cell lymphoma (AITL). Twelve cases were stage Ⅲ or Ⅳ lymphomas. The prognosis was overall poor. The histology, immunophenotype and TCR gene rearrangement were not significantly different from the corresponding types of lymphoma. Ki-67 proliferation index was over 70% in all cases. The expression of CD20 or CD79α was weak and heterogeneous. All 15 case of Ig gene rearrangement were polyclonal. Conclusions: Mature T/NK cell lymphoma with abnormal expression of CD20 or CD79α is rare, commonly found in advanced stage, and associated with poor prognosis. The expression of CD20 or CD79α in these cases is weaker than the corresponding mature T/NK cell lymphomas, while its proliferation index is higher. Histomorphology, extensive immunoprofiling and molecular detection are required for accurate diagnosis.

Clinicopathological features and BRAF V600E and MYD88 L265P mutation status of nodal marginal zone lymphoma / 中华病理学杂志

Objective: To investigate the clinicopathological features as well as BRAF V600E and MYD88 L265P mutation status of nodal marginal zone B cell lymphoma (NMZL). Methods: Thirty-two cases of NMZL were diagnosed from September 2009 to February 2021 at the Henan Provincial People's Hospital and Peking University School of Basic Medical Sciences. The clinicopathologic characteristics were obtained and analyzed. BRAF V600E and MYD88 L265P mutation status were identified using PCR and Sanger sequencing, respectively. Results: There were 20 males and 12 females patients with a median age of 69 years (ranging 36-82 years). The most prevalent clinical manifestation was multiple lymph nodes enlargement in head and neck (22/32, 68.8%), followed by inguinal (12/32, 37.5%), axillary (11/32, 34.4%), mediastinum (5/32, 15.6%) and retroperitoneal lymph nodes (4/32, 12.5%). Most of the patients were in Ann Arbor stage Ⅰ/Ⅱ (21 cases). The morphologic features included diffuse (24/32, 75.0%), nodular (5/32, 15.6%), interfollicular (2/32,6.3%) and perifollicular (1/32,3.1%) types. The tumor cells showed monocyte-like, centrocyte-like, small lymphocyte-like and plasma cell-like differentiation. Immunophenotyping revealed diffuse expression of CD20 in all tumor cells, whereas CD43 (11/32, 34.4%), bcl-2 (20/32, 62.5%), MNDA (13/32, 40.6%) and CD5 (2/32, 6.3%) were partially expressed. Ki-67 proliferation index varied from 10% to 40%. BRAF V600E mutation was found in two cases (2/32, 6.3%), but MYD88 L265P mutation was not detected. Eighteen patients survived and three died at the end of follow-up period which ranged 6 to 110 months. Conclusions: The morphologic features of NMZL varies across individuals, it should be differentiated from various B-cell lymphomas; however immunological biomarkers with high specificity for NMZL are still lacking. No MYD88 L265P mutation is found in NMZL. Some cases may harbor BRAF V600E mutation and yet the prevalence remains indeterminate; further researches are warranted.

Analysis of Clinical Characteristics in 595 Patients with Herb-induced Liver Injury / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe clinical characteristics of herb-induced liver injury (HILI).</p><p><b>METHODS</b>General conditions, medical history, clinical manifestations, biochemical indices, prognosis, and Roussed Uclaf Causality Assessment Method (RUCAM) scores were retrospectively analyzed in 595 inpatients at 302 Military Hospital between January 2009 and January 2014.</p><p><b>RESULTS</b>There were 423 cases (accounting for 71.1%) were females with multiple onset age ranging 41 to 50 years old. The median time from starting Chinese herbs to the occurrence of liver injury (LI) was 30 days (15-75 days), and 511 cases (85.9%) were classified as hepatocellular injury. Chinese herbs inducing HILI were mainly used for skin disease (102 cases, 17.1%), osteoarticular disease (57 cases, 9.6%), and gastrointestinal disease (49 cases, 8.2%), covering 207 kinds of Chinese patent medicines. Polygonum multiflorum, Psoralea corylifolia, and Corydalis ambigua were often seen in Chinese prescriptions. In RUCAM scoring, 451 HILI patients (accounting for 74.1%) were very possibly associated with Chinese herbs. Liver failure occurred in 47 HILI patients (accounting for 7.9%), cirrhosis in 45 patients (accounting for 7.6%), chronic HILI in 80 patients (accounting for 13.4%), 27 (4.5%) died, and only 2 (0.3%) underwent liver transplantation.</p><p><b>CONCLUSIONS</b>Chinese herbs could cause LI or even death. Attention should be paid to herbal hepatotoxicity and improving monitoring system of HILI.</p>

Short-term efficacy of treating hepatitis B virus-related acute-on-chronic liver failure based on cold pattern differentiation with hot herbs: A randomized controlled trial / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of Yinchen Zhufu Decoction (, YCZFD) in the treatment of acute-on-chronic liver failure caused by hepatitis B virus (HBV-ACLF) with cold pattern in Chinese medicine (CM).</p><p><b>METHODS</b>This is a multi-center randomized controlled trial of integrative treatment of CM and Western medicine (WM) for the management of HBV-ACLF patients. A total of 200 HBV-ACLF patients with cold pattern were equally randomly assigned to receive YCZFD and WM (integrative treatment) or WM conventional therapy alone respectively for 4 weeks. The primary end point was the mortality for HBV-ACLF patients. Secondary outcome measures included Model for End-Stage Liver disease (MELD) score, liver biochemical function, coagulation function and complications. Adverse events during treatment were reported.</p><p><b>RESULTS</b>The mortality was decreased 14.28% in the integrative treatment group compared with WM group (χ(2) =6.156, P=0.013). The integrative treatment was found to signifificantly improve the MELD score (t=2.353, P=0.020). There were statistically signifificant differences in aspartate transaminase, total bilirubin, indirect bilirubin, direct bilirubin and prothrombin time between the two groups (P<0.05 or P<0.01). The complications of ascites (χ(2)=9.033, P=0.003) and spontaneous bacteria peritonitis (χ(2)=4.194, P=0.041) were improved signifificantly in the integrative treatment group. No serious adverse event was reported.</p><p><b>CONCLUSIONS</b>The integrative treatment of CM and WM was effective and safe for HBV-ACLF patients with cold pattern in CM. The Chinese therapeutic principle "treating cold pattern with hot herbs" remains valuable to the clinical therapy. (Trial registration No. ChiCTR-TRC-10000766).</p>

Application of traditional Chinese medicine in the prevention and treatment of new sudden infectious disease / 药学学报

There has been thousands of years' history that traditional Chinese medicines were used in the prevention and treatment of infectious disease. In recent years, traditional Chinese medicine plays a unique role in the control of variety of new infectious diseases. This article provides a summary on our knowledge of the traditional Chinese medicine theory in the explanation of infectious disease, application of Chinese medicines and the pharmacological mechanism in the successful management on the Ebola virus disease.

Causes, Features, and Outcomes of Drug-Induced Liver Injury in 69 Children from China

BACKGROUND/AIMS: Drug-induced liver injury (DILI) is a frequent cause of pediatric liver disease; however, the data on DILI are remarkably limited. METHODS: All 69 children hospitalized with DILI between January 2009 and December 2011 were retrospectively studied. RESULTS: A total of 37.7% of the children had medical histories of respiratory infection. The clinical injury patterns were as follows: hepatocellular 89.9%, cholestatic 2.9%, and mixed 7.2%. Liver biopsies from 55 children most frequently demonstrated chronic (47.3%) and acute (27.3%) hepatitis. Hypersensitivity features, namely, fever (31.9%), rash (21.7%), and eosinophilia (1.4%), were found. Twenty-four children (34.8%) developed chronic DILI. Antibiotics (26.1%) were the most common Western medicines (WMs) causing DILI, and the major implicated herbs were Ephedra sinica and Polygonum multiflorum. Compared with WM, the children whose injuries were caused by Chinese herbal medicine (CHM) showed a higher level of total bilirubin (1.4 mg/dL vs 16.6 mg/dL, p=0.004) and a longer prothrombin time (11.8 seconds vs 17.3 seconds, p=0.012), but they exhibited less chronic DILI (2/15 vs 18/39, p=0.031). CONCLUSIONS: Most cases of DILI in children are caused by antibiotics or CHM used to treat respiratory infection and present with hepatocellular injury. Compared with WM, CHM is more likely to cause severe liver injury, but liver injury caused by CHM is curable.

Reconstruction of soft-tissue defect in the middle and distal thirds of the leg with the soleus muscle flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of surgical method with the soleus muscle flap for repairing the soft-tissue defects in the middle and distal thirds of the leg, combined with open tibial fracture and/or osteomyelitis.</p><p><b>METHODS</b>From May 2007 to December 2011, 8 cases with soft-tissue defects in the middle and distal thirds of the leg were treated with soleus muscle flaps, including 5 cases with chronic osteomyelitis and 3 cases with open tibial fracture and acute osteomyelitis. The defects size ranged from 8 cm x 6 cm to 12 cm x 10 cm. The surface of muscle flaps was covered by split-thickness skin graft. The defects at the donor site were closed directly.</p><p><b>RESULTS</b>All the muscle flaps and skin grafts survived completely and fracture was healed. The patients were followed up for 2 to 54 months with satisfactory cosmetic and functional results.</p><p><b>CONCLUSIONS</b>The soleus muscle flap is an effective and feasible method for reconstruction of the soft-tissue defects in the middle and distal thirds of the leg, combined with open tibial fracture and/or osteomyelitis. The morbidity at donor sites is also minor.</p>

Relationship between HBV DNA genotype and Chinese medicine syndrome pattern in patients with chronic hepatitis B / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the relationship between genotype of HBV DNA and Chinese medicine (CM) syndrome pattern in patients with chronic hepatitis B (CHB).</p><p><b>METHODS</b>With an open parallel-controlled method adopted, CM syndrome types of 117 CHB patients were differentiated and their genotypes of HBV DNA in peripheral blood were determined to observe the relationship with syndrome pattern and diagnostic degree of hepatitis.</p><p><b>RESULTS</b>(1) The HBV DNA genotype distribution in CHB patients was: type B in 17.51% (31 cases) of the 117 patients, type C in 131 (74.01%), type B/C in 11 (6.21%) and type D in 1 (0.56%), while the genotype in 3 cases was unable be determined. The proportion of patients with HBV DNA of type C was obviously higher than that with other types (P < 0.01). (2) Distribution of CM syndrome pattern was: 98 patients (55.37%) were differentiated as Gan-stagnation Pi-deficiency pattern (I), 6 (3.39%) as Gan-Shen yin-deficiency pattern (II), 2 (1.13%) as Pi-Shen yang-deficiency pattern (III), 12 (6.78%) as damp-heat blocking pattern (IV) and 59 (33.33%) as blood-stasis obstruction pattern (V). Sixteen out of the 32 severe CHB patients were differentiated as pattern V, accounting for 50.00%, but showed no statistical difference in comparing with that in patients of other patterns. However, the HBeAg negative rates in patients of pattern V was 62.71% (37/59), significantly higher than that in patients of other patterns (P = 0.00), suggesting that the inflammatory injury of liver was rather severer, and the virus were eliminated partially in the inflammatory reaction. (3) 42.37% (25/59) in patients of pattern V had family history of CHB, the percentage was significantly higher than that in patients of pattern I (P < 0.05).</p><p><b>CONCLUSIONS</b>HCV DNA of type C is predominant in CHB patients in China. Liver injury in CHB patients of CM syndrome pattern V is severer than that in patients of other patterns. HBV genotype shows no obvious correlativity with CM syndrome pattern of patients, but the cases with family CHB infection history of pattern V take a higher proportion.</p>

Observation on the therapeutic effects of negative-pressure wound therapy on the treatment of complicated and refractory wounds / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the effects of negative-pressure wound therapy (NPWT) on the treatment of complicated and refractory wounds.</p><p><b>METHODS</b>Sixty-seven patients with complicated or refractory wounds admitted to our hospital from September 2005 to November 2008 were randomly divided into NPWT group (n = 35) and conventional treatment (CT) group (n = 32). Wounds of patients in NPWT group were treated with interrupted suction under a pressure of -16.63 kPa for 24 hs, or continuous suction under a pressure of -10.64 kPa for 24 hs. Wounds of patients in CT group were covered with petrolatum gauze overlaid with isotonic saline gauze and dry gauze. Duration of treatment, times of operation, treatment cost, and the process of healing were compared between two groups.</p><p><b>RESULTS</b>The duration of treatment, treatment cost and times of operation of patients in NPWT group were obviously less or fewer than those of CT group (P < 0.05). Wounds of patients in NPWT group were mainly healed by themselves (40.0%) or healed after free skin grafting (40.0%). While wounds in patients in CT group healed mainly after tissue flap transplantation (66.7%) or free skin grafting (23.3%).</p><p><b>CONCLUSIONS</b>Compared with CT, NPWT can shorten the length of hospital stay, reduce operation frequency and treatment cost, and it is easier to carry out in the surgery of treating complicated and refractory wounds, which is worth generalization.</p>

A comparative study of the clinical effects between two kinds of negative-pressure wound therapy / 中华烧伤杂志

<p><b>OBJECTIVE</b>To compare the differences of the clinical effects, side effects and treatment-related cost between two kinds of negative-pressure wound therapy (NPWT).</p><p><b>METHODS</b>Forty-four inpatients with acute, subacute, and chronic wounds were divided into simplified NPWT group (A group) and conventional NPWT group (B group) according to the random number table. Wounds of patients in A group were treated with gauze + continuous suction with hospital central negative pressure (-10.64 kPa) for 24 hs; wounds of patients in B group were treated with sponge + interrupted suction with a purpose-designed suction appliance (-16.63 kPa) for 24 hs. Gross wound condition, treatment time, survival rates of skin graft and flap, changes of bacterial species on wound, treatment cost, and ratio of side effects between two groups were compared.</p><p><b>RESULTS</b>There was no significant difference between A and B groups in respect of gross wound condition, treatment time [A group (29 +/- 12) d, B group (26 +/- 13) d, P > 0.05], changes of bacterial species, survival rates of skin graft [A group (98 +/- 4)%, B group (98 +/- 4)%, P > 0.05] and flap (A group 98%, B group 100%, P > 0.05). Treatment cost of A group yen(374 +/- 134) was obviously lower than that of B group yen(9825 +/- 4956) (P < 0. 01), while more side effects were observed in A group (33.3%) than that in B group (5.0%) (P < 0.05).</p><p><b>CONCLUSIONS</b>Both simplified NPWT and NPWT with purpose-designed appliance can effectively improve wound healing. The simplified method may cause many side effects and has a potential risk of inciting nosocomial infection, but it can be conveniently employed with a low cost. In contrast, the cost of using purpose-designed appliance should be cut down to meet the aim of generalization.</p>

The influence of Ad-AVEGF165 on human malignant melanoma growth in nude mice / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of antisense VEGF165 infection on the growth of A375 cells in nude mice.</p><p><b>METHODS</b>A375 cells were injected s.c into the axilla of the nude mouse. After the tumor formed, we cut it into 16 pieces equally, then transplanted into another 15 nude mice. There were three groups: Group PBS, Group Ad-GFP, and Group Ad-aVEGF. Four weeks after interfere, the mice were sacrificed and their tumors were excised for naked eye and histological observation. The VEGF expression was checked with ISH and immunohistochemistry staining. The micro-vessel density (MVD) in tumor mass was counted by VIII factor immunohistochemistry staining.</p><p><b>RESULTS</b>The visible and palpable nodules had developed at all the injected sites. Tumor growth speed was more slowly in Group Ad-aVEGF than that in other groups. GFP gene could express effectively in tumor mass. Ad-aVEGF infection could suppress the growth of tumors, and there were no obvious side effects. Ad-aVEGF resulted more tissue necrosis, but it had no obvious effect on cell apoptosis. VEGF expression was inhibited significantly in Group Ad-aVEGF, and MVD was decreased accordingly.</p><p><b>CONCLUSIONS</b>Ad-aVEGF interfere may be a new method against human malignant melanoma, whose main mechanism is to induce ischemia, but not apoptosis.</p>