Primary testicular diffuse large B-cell lymphoma: a single center experience / 中华泌尿外科杂志

Objective To review the experience of the clinical diagnosis and treatment of primary testicular diffuse large B-cell lymphoma.Methods A review was made who were treated in the Tumor Hospital of Zhengzhou University from January 2011 to November 2018.The average age of the patients was 58 years old,with 4 cases in left side and 8 cases in right side.All patients were admitted to hospital with painless testicle mass.Solid mass of testis were detected by ultrasound with no abnormality in tumor markers.All patients underwent orchiectomy and followed by chemotherapy.Results Twelve primary testicular lymphoma (PTL) were identified by pathology,with 8 cases in phase Ⅰ,2 cases in phase Ⅱ,1 case in phase Ⅲ,and 1 case in phase Ⅳ.The mean follow-up was 31 months.Inguinal orchiectomy was recommended as a diagnositc and initial therapy.All patients underwent R-CHOP/CHOP chemotherapy consisting of cyclophosphamide,doxorubicin,vincristine and prednisone with or without rituximab,including 6 cases with R-CHOP and 6 cases with CHOP.Nine of 12 patients underwent intrathecal prophylatic chemotherapy and 6 of 12 patients underwent contralateral testicle radiotherapy.Relapse occured in 2 patient with CHOP in central nervous system and died of the disease.One case with CHOP relapsed in abdominal cavity.No contralateral testicle relapse was observed.Conclusions PTL is a rare extranodal lymphoma.Painless testicle tumor in men over 50 years old should suspect of this disease.Inguinal orchiectomy is an important part of the treatment,which combines systemic chemotherapy and prophylactic modalities such as radiotherapy of contralateral testis and/or central nervous system (CNS) prophylaxis.

Clinical features and management of primary bladder lymphoma / 中华泌尿外科杂志

Objective@#To summarize the clinical experience of primary bladder lymphoma.@*Methods@#From September 2012 to May 2019, 8 cases of primary bladder lymphoma treated in our institute were analyzed retrospectively, including 4 males and 4 females. The mean age was 50.5 years old, ranged from 15 to 85. There were 3 cases of localized bladder lymphoma and 5 cases of metastatic bladder lymphoma. Three cases presented with painless gross hematuria primarily and 5 cases suffered from abdominal pain and bloating. Imaging examination showed the bladder tumor or pelvic mass with maximum diameter ranged from 3 to 22 cm, with 11.3 cm on average. Preoperative diagnosis of bladder tumor in 3 cases, and pelvic malignant tumor in 5 cases. Two patients underwent TURBT and 6 cases underwent pelvic mass resection and partial cystectomy.@*Results@#Postoperative pathological diagnosis showed 6 cases of diffuse large B-cell lymphoma, 1 case of mucosa-associated lymphoid tissue lymphoma, 1 case of anaplastic large cell lymphoma. Follow-up after surgery ranged 3 to 60 months, with 28.1 months on average. Two patients can not tolerate radiotherapy or chemotherapy for postoperative complications of vesico-vaginal fistula and intestinal fistula, and both were alive at the last follow-up. Six patients underwent CHOP regimen (cyclophosphamide, doxorubicin, vincristine, prednisone), 3 cases were addd with rituximab. Three patients died during the follow-up. One 85-year-old patient died 10 months after surgery. Two cases of metastatic bladder lymphoma died 3 or 6 months after surgery respectively. Three cases were alive after chemotherapy, including 2 young patients undergoing chemotherapy with DICE regime and one patient undergoing pelvic radiotherapy.@*Conclusion@#The primary bladder lymphoma has no special clinical symptoms, and TURBT and needle biopsy are critical for the diagnosis, based on the pathological and immunohistochemical examination. The most common pathological type is diffuse large B-cell lymphoma. R-CHOP chemotherapy is recommended, which can be followed by DICE regime for young patients. Metastasis and aging predict poor prognosis.

Clinical features and management of primary bladder lymphoma / 中华泌尿外科杂志

Objective To summarize the clinical experience of primary bladder lymphoma.Methods From September 2012 to May 2019,8 cases of primary bladder lymphoma treated in our institute were analyzed retrospectively,including 4 males and 4 females.The mean age was 50.5 years old,ranged from 15 to 85.There were 3 cases of localized bladder lymphoma and 5 cases of metastatic bladder lymphoma.Three cases presented with painless gross hematuria primarily and 5 cases suffered from abdominal pain and bloating.Imaging examination showed the bladder tumor or pelvic mass with maximum diameter ranged from 3 to 22 cm,with 11.3 cm on average.Preoperative diagnosis of bladder tumor in 3 cases,and pelvic malignant tumor in 5 cases.Two patients underwent TURBT and 6 cases underwent pelvic mass resection and partial cystectomy.Results Postoperative pathological diagnosis showed 6 cases of diffuse large B-cell lymphoma,1 case of mucosa-associated lymphoid tissue lymphoma,1 case of anaplastic large cell lymphoma.Follow-up after surgery ranged 3 to 60 months,with 28.1 months on average.Two patients can not tolerate radiotherapy or chemotherapy for postoperative complications of vesico-vaginal fistula and intestinal fistula,and both were alive at the last follow-up.Six patients underwent CHOP regimen (cyclophosphamide,doxorubicin,vincristine,prednisone),3 cases were addd with rituximab.Three patients died during the follow-up.One 85-year-old patient died 10 months after surgery.Two cases of metastatic bladder lymphoma died 3 or 6 months after surgery respectively.Three cases were alive after chemotherapy,including 2 young patients undergoing chemotherapy with DICE regime and one patient undergoing pelvic radiotherapy.Conclusion The primary bladder lymphoma has no special clinical symptoms,and TURBT and needle biopsy are critical for the diagnosis,based on the pathological and immunohistochemical examination.The most common pathological type is diffuse large B-cell lymphoma.RCHOP chemotherapy is recommended,which can be followed by DICE regime for young patients.Metastasis and aging predict poor prognosis.

Development and Changes of the United States Medical Licensing Examination(USMLE) / 中华医院管理杂志

Purpose of this study is to re-compute and analyze the hospitalization rates of residents in China and explore the methodology of systematic review in health policy research.Methodology:DThanks to a history of 90 years,USMLE has evolved into a mature system of international recognition in the industry.This paper covers the history and changes of USMLE and details its goals construction and implementation,examination question selection model,procedures and principles,selection of criteria and the development trends.

Subject Diagnostic Analysis on the Medical licensing Examinationof Clinical Medical Students / 中华医学教育探索杂志

The aim of China National Medical Licensing Examination (CNMLE) is to check and assess examinee's requirement for medical practice. In a certain extent, the score result of Medical Licensing Examination reflects the examinee's mastery degree of knowledge, ability and skills (SAKs) learned in medical school. Through the subject diagnostic analysis on the Medical Licensing Examination for certain samples, this research reviewed the clinical medical student's mastery degree of different SAKs. The author wishes the conclusion of this paper would be helpful to some aspects of medical education.

A comparative study on the composition of candidates for the doctor qualification examination in different regions / 中华医院管理杂志

Using registration information on candidates for the written examination in medical synthesis, a part of the doctor qualification examination, from 1999 to 2001 as processing data, the authors made a comparative study on the composition of the candidates in the eastern, middle and western regions of the country from 7 aspects, viz. total number, category of registration for the examination, educational background, time of graduation, age, organization and rank of organization. It was found that the educational background of the candidates was on the whole very low and the number and quality of health personnel in the western region and at the grass roots level was in dire need of enhancement.