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G protein-coupled receptors (GPCRs) are the largest family of membrane receptors in animals and humans, which transmit various signals from the extracellular environment into cells. Studies have reported that several GPCRs transmit the same signal; however, the mechanism is unclear. In the present study, we identified all 122 classical GPCRs from the genome of Helicoverpa armigera, a lepidopteran pest species. Twenty-four GPCRs were identified as upregulated at the metamorphic stage by comparing the transcriptomes of the midgut at the metamorphic and feeding stages. Nine of them were confirmed to be upregulated at the metamorphic stage. RNA interference in larvae revealed the prolactin-releasing peptide receptor (PRRPR), smoothened (SMO), adipokinetic hormone receptor (AKHR), and 5-hydroxytryptamine receptor (HTR) are involved in steroid hormone 20-hydroxyecdysone (20E)-promoted pupation. Frizzled 7 (FZD7) is involved in growth, while tachykinin-like peptides receptor 86C (TKR86C) had no effect on growth and pupation. Via these GPCRs, 20E regulated the expression of different genes, respectively, including Pten (encoding phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase), FoxO (encoding forkhead box O), BrZ7 (encoding broad isoform Z7), Kr-h1 (encoding Krüppel homolog 1), Wnt (encoding Wingless/Integrated) and cMyc, with hormone receptor 3 (HHR3) as their common regulating target. PRRPR was identified as a new 20E cell membrane receptor using a binding assay. These data suggested that 20E, via different GPCRs, regulates different gene expression to integrate growth and development.

Purpose. To evaluate the diagnostic performance of deep learning with a multichannel fusion three-dimensional convolutional neural network (MCF-3DCNN) in the differentiation of the pathologic grades of hepatocellular carcinoma (HCC) based on dynamic contrast-enhanced magnetic resonance images (DCE-MR images). Methods and Materials. Fifty-one histologically proven HCCs from 42 consecutive patients from January 2015 to September 2017 were included in this retrospective study. Pathologic examinations revealed nine well-differentiated (WD), 35 moderately differentiated (MD), and seven poorly differentiated (PD) HCCs. DCE-MR images with five phases were collected using a 3.0 Tesla MR scanner. The 4D-tensor representation was employed to organize the collected data in one temporal and three spatial dimensions by referring to the phases and 3D scanning slices of the DCE-MR images. A deep learning diagnosis model with MCF-3DCNN was proposed, and the structure of MCF-3DCNN was determined to approximate clinical diagnosis experience by taking into account the significance of the spatial and temporal information from DCE-MR images. Then, MCF-3DCNN was trained based on well-labeled samples of HCC lesions from real patient cases by experienced radiologists. The accuracy when differentiating the pathologic grades of HCC was calculated, and the performance of MCF-3DCNN in lesion diagnosis was assessed. Additionally, the areas under the receiver operating characteristic curves (AUC) for distinguishing WD, MD, and PD HCCs were calculated. Results. MCF-3DCNN achieved an average accuracy of 0.7396±0.0104 with regard to totally differentiating the pathologic grade of HCC. MCF-3DCNN also achieved the highest diagnostic performance for discriminating WD HCCs from others, with an average AUC, accuracy, sensitivity, and specificity of 0.96, 91.00%, 96.88%, and 89.62%, respectively. Conclusions. This study indicates that MCF-3DCNN can be a promising technology for evaluating the pathologic grade of HCC based on DCE-MR images.

Background With the development of new magnetic resonance imaging (MRI) techniques, an increasing number of articles have been published regarding hepatocellular carcinoma magnetic resonance imaging (HCCMRI) in the past decade. However, few studies have statistically analyzed these published articles. In this study, we aim to systematically evaluate the scientific outcomes of HCCMRI research and explore the research hotspots from 2008 to 2017. Methods The included articles regarding HCCMRI research from 2008 to 2017 were downloaded from the Web of Science Core Collection and verified by two experienced radiologists. Excel 2016 was used to analyze the literature data, including the publication years and journals. CiteSpace V was used to perform co-occurrence analyses for authors, countries/regions and institutions and to generate the related collaboration network maps. Reference co-citation analysis (RCA) and burst keyword detection were also performed using CiteSpace V to explore the research hotspots in the past decade. Results A total of 835 HCCMRI articles published from 2008 to 2017 were identified. Journal of Magnetic Resonance Imaging published the most articles (79 publications, 9.46%). Extensive cooperating relationship were observed among countries/regions and among authors. South Korea had the most publications (199 publications, 21.82%), followed by the United States of America (USA) (190 publications, 20.83%), Japan (162 publications, 17.76%), and the People's Republic of China (148 publications, 16.23%). Among the top 10 co-cited authors, Bruix J (398 citations) was ranked first, followed by Llovet JM (235 citations), Kim YK (170 citations) and Forner A (152 citations). According to the RCA, ten major clusters were explored over the last decade; "LI-RADS data system" and "microvascular invasion" (MVI) were the two most recent clusters. Forty-seven burst keywords with the highest citation strength were detected over time. Of these keywords, "microvascular invasion" had the highest strength in the last 3 years. The LI-RADS has been constantly updated with the latest edition released in July 2018. However, the LI-RADS still has limitations in identifying certain categories of lesions by conceptual and non-quantitative probabilistic methods. Plenty of questions still need to be further answered such as the difference of diagnostic efficiency of each major/ancillary imaging features. Preoperative prediction of MVI of HCC is very important to therapeutic decision-making. Some parameters of Gd-EOB-DTPA-enhanced MRI were found to be useful in prediction of MVI, however, with a high specificity but a very low sensitivity. Comprehensive predictive model incorporating both imaging and clinical variables may be the more preferable in prediction of MVI of HCC. Conclusions HCCMRI-related publications displayed a gradually increasing trend from 2008 to 2017. The USA has a central position in collaboration with other countries/regions, while South Korea contributed the most in the number of publications. Of the ten major clusters identified in the RCA, the two most recent clusters were "LI-RADS data system" and "microvascular invasion", indicative of the current HCCMRI research hotspots.

BACKGROUND: The accurate assessment of liver fibrosis is essential for patients with chronic liver disease. A liver biopsy is an invasive procedure that has many potential defects and complications. Therefore, noninvasive assessment techniques are of considerable value for clinical diagnosis. Liver and spleen magnetic resonance elastography (MRE) and serum markers have been proposed for quantitative and noninvasive assessment of liver fibrosis. This study aims to compare the diagnostic performance of liver and spleen stiffness measured by MRE, fibrosis index based on the 4 factors (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), and their combined models for staging hepatic fibrosis. METHODS: One hundred and twenty patients with chronic liver disease underwent MRE scans. Liver and spleen stiffness were measured by the MRE stiffness maps. Serum markers were collected to calculate FIB-4 and APRI. Liver biopsies were used to identify pathologic grading. Spearman’s rank correlation analysis evaluated the correlation between the parameters and fibrosis stages. Receiver operating characteristic (ROC) analysis evaluated the performance of the four individual parameters, a liver and spleen stiffness combined model, and an all-parameters combined model in assessing liver fibrosis. RESULTS: Liver stiffness, spleen stiffness, FIB-4, and APRI were all correlated with fibrosis stage (r=0.87, 0.64, 0.65, and 0.51, respectively, all P0.05). CONCLUSIONS: Liver stiffness measured with MRE had better diagnostic performance than spleen stiffness, APRI, and FIB-4 for fibrosis staging. The combined models did not significantly improve the diagnostic value compared with liver stiffness in staging fibrosis.

Interstitial pneumonia (IP) is a lethal complication in lymphoma patients undergoing chemotherapy. A total of 2212 consecutive patients diagnosed with lymphoma between 2009 and 2014 were enrolled in the present study. IP was defined as diffuse pulmonary interstitial infiltrate found on computed tomography scans. IP was observed in 106 patients. Of these, 23 patients were excluded from the study. Finally, 83 patients with IP were included in this study. The incidence of IP was 3.9% (7/287) in Hodgkin lymphoma and 2.4% (76/1925) in non-Hodgkin lymphoma (P = 0.210). The median number of chemotherapy cycles before IP was 3. The median time from the cessation of chemotherapy to IP was 17 days. Eighty-two (98.8%) patients recovered after the treatment with glucocorticoids. Sixty-six (79.5%) patients had a delay in chemotherapy, and 14 (16.9%) patients had premature termination of chemotherapy. Sixty-nine patients were re-treated with chemotherapy after remission from IP, of which 22 (31.9%) experienced IP recurrence. The incidence of IP recurrence was significantly higher in patients re-treated with a similar regimen than in those re-treated with an alternative regimen (65.4 vs. 11.6%, P

Background Accurate preoperative assessment of the pathological grade of hepatocellular carcinoma (HCC) could greatly benefit prognostic predictions. Purpose To assess and compare the diagnostic accuracy of the apparent diffusion coefficient (ADC) and tissue diffusivity (D) for the noninvasive pathological grading of HCC. Study type Meta-analysis. Data sources PubMed/Medline, EMBASE, the Web of Science, and the Cochrane Library were searched to find related original articles published up to May 30, 2019. Field strength/sequence Diffusion-weighted imaging (DWI) and/or intravoxel incoherent motion (IVIM) were performed with a 1.5T or 3.0T scanner. Assessment The Quality Assessment of Diagnostic Accuracy Studies 2 tool was used to assess the methodologic quality. Statistical tests The bivariate random-effects model was used to obtain the pooled sensitivity and specificity, and the area under summary receiver operating characteristic curve (AUROC) was obtained. Subgroup analyses were performed. Results A total of 16 original articles (1428 HCCs) were included. Most studies had a low to unclear risk of bias and minimal concerns regarding applicability. For the discrimination of well-differentiated HCCs, the pooled sensitivity and specificity of the ADC value were 85% and 92%, respectively. For the discrimination of poorly differentiated HCCs, the pooled sensitivity and specificity of the ADC value and D were 84% and 80%, and 92% and 77%, respectively. The summary AUROC of D (0.94) was significantly higher than that of ADC (0.89) (z = -2.718, P = 0.007). The subgroup analyses identified three covariates including size, number of included lesions in the studies, and blindness to the reference standard as possible sources of heterogeneity. Data conclusion This meta-analysis showed that the ADC and D values had a high to excellent accuracy for the noninvasive pathological grading of HCCs and that the D value was superior to the ADC value for discriminating poorly differentiated HCCs. Level of evidence 3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:1581-1593.

Background The value of prophylactic antiviral therapy in patients with past hepatitis B virus (HBV) infection (HBV surface antigen-negative/anti-HBV core antibody-positive/HBV DNA negative) is still controversial. Patients and Methods This study compared the safety, efficacy, and cost-effectiveness of prophylactic entecavir (ETV) with regular monitoring alone in lymphoma patients with past HBV infection. Patients were randomly assigned to chemotherapy alone (control) or prophylactic ETV before chemotherapy and at least 6 months after completion of chemotherapy. All patients underwent close virologic and biochemical surveillance. The primary end points were the incidence rates of HBV reactivation (appearance of HBV DNA) and HBV reactivation-related hepatitis (defined as a greater than 3-fold increase in serum alanine aminotransferase levels exceeding 100 IU/L). Results A total of 190 patients were included, 141 (74.2%) of whom were positive for anti-HBV surface antibody (HBs). The incidence rates of HBV reactivation and HBV reactivation-related hepatitis were 0 (0/95) and 0 (0/95) in the prophylactic ETV group, respectively, and 3.2% (3/95) and 1.1% (1/95) in the control group, respectively (P = .246 and 1.000, respectively). One patient experienced HBV reactivation-related hepatitis, resulting in premature termination of chemotherapy. All 3 patients with HBV reactivation recovered after therapeutic ETV treatment. No HBV-related deaths were observed during the follow-up period. The cost in the prophylactic ETV group was higher than that in the control group ($125 per month). Conclusion Prophylactic antiviral therapy is not a cost-effective strategy for the management of lymphoma patients with past HBV infection, especially those positive for anti-HBs.

Dynamic contrast-enhanced magnetic resonance imaging provide not only the information on the morphological features of the lesions, but also the changes of the lesion’s blood perfusion. In this paper, we propose a tensor-based temporal data representation (TTD) model and a multi-channel fusion 3D convolutional neural network (MCF-3D CNN) to extract the temporal and spatial features of dynamic contrast enhanced-MR images (DCE-MR images). To evaluate the performance of the proposed methods, we established a DCE-MR image dataset for non-invasively assessing the differentiation of Hepatocellular carcinoma (HCC). The TTD model achieves the accuracy of 73.96% for non-invasive assessment of HCC differentiation via MCF-3D CNN. Meanwhile, the 3D CNN with TTD achieves accuracy, sensitivity and specificity of 95.17%, 96.33%, and 94.00%, respectively, in discriminating the HCC and cirrhosis. Compared with the normal data representation method, the proposed TTD method is more conducive for 3D CNN to extract temporal-spatial features of DCE-MR images.

Primary membranous nephropathy (PMN) is an antibody-mediated autoimmune glomerular disease. The incidence of PMN is 10/million populations/year and mostly adult patients present with nephrotic syndrome (NS). Moreover, the patients with persistent NS progressed to end-stage renal disease in 5–15 years. A number of studies proved the efficiency of immunosuppressant. Combinations of corticosteroid with alkylating agents or calcineurin inhibitor (CNI) have been proved to be effective to induce remission of PMN with persistent heavy proteinuria. However, there are still 30% PMN patients refractory or dependent to immunosuppressant. A few studies showed rituximab (RTX) may be effective to treat refractory PMN with the protocol varies. The doses of 375 mg/m2 every week for 4 weeks and 1 g fixed dose with a repeat dose in 2 weeks were commonly used. Nonetheless, some studies about anti-neutrophil cytoplasmic antibody-associated vasculitis, rheumatoid arthritis (RA), autoimmune cytopenias, focal segmental glomerulosclerosis, and so on showed a low-dose or single-dose RTX can be effective on proteinuria remission and peripheral blood B-cells elimination. Hereon, we present a 51-year-old refractory PMN patient who was induced complete remission by a low-dose RTX. A 51-year-old Chinese man was admitted to our hospital complaining persistent edema of lower extremities for 2 years. He was diagnosed as NS and received renal biopsy in another hospital 2 years ago. Pathologic study showed membranous nephropathy [Figure 1]. A full dose of ACE inhibitors, prednisolone in combination with cyclophosphamide (“Ponticelli Regimen”) for 6 months failed to induce remission. One year ago, the man was referred to our clinic department. Combination of prednisolone (10 mg/d) with tacrolimus (2–2.5 mg/d) was initiated. Diltiazem were added to increase tacrolimus trough concentration to the range of 5.5–9.8 ng/ml. After 7-month treatment, the patient had not improved and was admitted to our inpatient department. Figure 1 Pathology of renal biopsy. (a) electron microscopy: Subepithelial deposits of immunocomplex, thickening of glomerular basement membrane, effacement of podocyte foot. (b) Light microscopy: Inflammatory cells infiltration and part of the renal tubular atrophy. ... Physical examination was nonspecific except edema of lower extremities. The urine protein was 6.5 g/d, urine protein-to-creatinine (Cr) ratio was 0.663 g/mmol Cr, serum Cr was 15.8 mg/L, and serum albumin was 28 g/L. The blood lipid levels suggested hyperlipidemia. The plasma trough concentration of tacrolimus was 8.7 ng/ml. The CD19CD5 B-cells was 314 cell/μl (12.20%). The blood routine tests were normal and immune indices were negative. Markers and imaging tests for tumor were normal. Hepatitis B surface antigen was negative. Anti-hepatitis B core, anti-hepatitis B e antibody were positive and hepatitis B virus-DNA 0.6 g/mmol Cr. 100 mg rituximab was given to him combining with the former immunosuppresive protocol at 7 months. Six ... RTX is a B-cell depleting monoclonal antibody targets at CD20, a transmembrane protein expressed on virtually all B-cells except when B-cells differentiate into antibody secreting plasma cells. RTX binding to CD20 initiates B-cells apoptosis, complement dependent cytotoxicity and antibody-dependent cell-mediated cytotoxicity. RTX was first used to treat non-Hodgkin lymphoma in 1997 and be confirmed to be effective in RA, idiopathic thrombocytopenic purpura, pemphigus, and so on. RTX was also gradually used in a wide variety of glomerular diseases including lupus nephritis, IgA nephropathy, minimal change disease and focal segmental glomeruloslcerosis, fibrillary glomerulonephritis, and membranous nephropathy. Recently, a systematic review[1] which searched the available data on RTX therapy for MN from inception to August 1, 2008, recruited 21 case reports or case series and 85 patients without control. Among the 21 reports, the patients were given RTX at a high dose of 375 mg/m2 once weekly for 4 weeks or 1 g RTX on days 1 and 15. RTX treatment can be repeated if the circulating B-cells and proteinuria not reach the remission rang (>3.5 g/d or

Hybrid thiol-silica spheres constructed by interlacing arrays of submicrometer-sized blocks and large macropores were fabricated by a one-pot approach and were successfully used for the fast capture of heavy metal ions with a total capture time of less than 2 min.

pH was controlled to 3.0 or 10.0, with pH uncontrolled as blank, to study the release of ammonia and phosphate for different kinds of waste sludge, namely primary sludge (PS), waste activated sludge (WAS), and mixed sludge (MS) composed of PS and WAS at a ratio. The results show that acidity and alkalinity has different effects on different kinds of sludge at room temperature. When the pH is controlled to 10.0, it is observed that ammonia for PS and WAS is rapidly released to the top, 6.53mg/g TS and 8.40mg/g TS on the 4th day. But from the peak value on, the release amount shows downward until the experiment period ends. At pH 3.0 the release amount for PS is little, even less than the blank test, while the release amount for WAS is higher at pH 3.0 in all the period, and arrives at the maximum 10.07mg/g TS on the 6th day, after which the values keep relatively stable. Compared with the release of ammonia, the changes of release amount of phosphate is similar to the two kinds of waste sludge mentioned above, acidity>alkalinity>blank test ,and the amount at pH 10.0 is close to the blank test. Because of high percentage of PS, the release law of ammonia for MS is similar to PS. The order of release amount is as follows: alkalinity>blank test>acidity, but PS is different , the release amount at pH 10.0 always keeps rising until the period ends. The release of phosphate is consistent with the PS and WAS except that it is inhibited under alkaline condition.

The exact incidence and severity of hepatitis B virus (HBV) reactivation after the withdrawal of prophylactic antiviral therapy (delayed HBV reactivation) is unknown. We retrospectively analyzed 107 newly diagnosed diffuse large B cell lymphoma patients with HBV infection who received chemotherapy. The median time from the cessation of antitumor therapy to the withdrawal of prophylactic antiviral therapy was 6.1 months. The incidence of delayed HBV reactivation was 21.7% in HBsAg-positive group and 0 in HBsAg-negative/anti-HBc-positive group (P 0.001). No HBV-related fulminant hepatitis or hepatitis-related death occurred. The multivariate analysis showed that female gender and lengthy cycles of chemotherapy (8 cycles) were independent risk factors of HBV reactivation in HBsAg-positive patients. In conclusion, prophylactic antiviral therapy could be withdrawn 6 months after the cessation of chemotherapy in HBsAg-negative/anti-HBc-positive patients. However, a longer course of prophylactic antiviral drug administration may be an optimal option to prevent delayed HBV reactivation for HBsAg-positive patients.

Citrus allotetraploid somatic hybrids obtained via protoplast fusion have been employed as pollen/seed parents in interploidy crosses to produce triploid plants aiming to develop seedless citrus. However, their meiotic behavior, which directs the parental heterozygosity transmission, has been rarely explored. In this study, the meiotic inheritance pattern was evaluated in a citrus allotetraploid somatic hybrid between ‘Nova’ tangelo and ‘HB’ (Hirado Buntan) pummelo through cytogenetic observation of meiosis and segregation analysis using 18 simple sequence repeat (SSR) markers. Meiotic analysis of pollen mother cells (PMCs) showed a high rate of quadrivalents (31.6 %) in this allotetraploid although bivalents were predominant (57.6 %). For segregation analysis, the meiotic chromosome-pairing behavior was analyzed by genotyping a triploid population derived from a cross between diploid ‘Nadorcott’ tangor and this allotetraploid using the microsatellite DNA allele counting-peak ratios (MAC-PR) method, from which the genotypes of diploid male gametes were inferred. In agreement with the expectation of cytogenetic analysis, a mixture of diploid, tetraploid, and intermediated inheritance patterns was deduced due to the co-existence of preferential, non-preferential, and intermediate pairing models among all analyzed loci. Parental heterozygosity transmission was further analyzed among 14 loci where each chromosome in the allotetraploid could be clearly tracked. It showed that the mean value of 23.8 % intra-parental and 76.2 % inter-parental heterozygosity was transmitted. The preferential pairing pattern at the loci displaying an intermediate inheritance pattern was also discussed.

2 n megagametophyte formation plays an important role in polyploidization in polyembryonic citrus and is valuable for plant improvement. Tetraploid plants are frequently observed in the seedlings of diploid polyembryonic citrus genotypes. However, the mechanisms underlying the formation of tetraploids are still indistinct when apomictic citrus genotypes are used as female parent to cross with tetraploids. Herein, 54 tetraploid progenies, which were unexpectedly obtained previously from four 2x × 4x crosses using polyembryonic ‘Nadorcott’ tangor as seed parent, were analyzed by 22 simple sequence repeat (SSR) markers, aiming to reveal their genetic origin and the mechanism underlying 2n megagametophyte formation. The results showed that 13 tetraploids from all these four crosses were doubled diploids as indicated by their identical SSR allelic profile with their female parent; while the remaining 41 tetraploids apparently exhibited paternally derived alleles, which confirmed their zygotic origin. Furthermore, the genotyping of all hybrids indicated that all of them arose from 2n megagametophytes. Based on the genotypes of 2n megagametophytes, the analysis of maternal heterozygosity restitution (HR) for each marker showed that it varied from 0.00 to 87.80 % with a mean value of 40.89 %. In addition, it was observed that 13 markers displayed a lower rate than 50 %. On the basis of the above results, it can be speculated that the second division restitution (SDR) is the mechanism underlying the 2n megagametophyte formation in ‘Nadorcott’ tangor. The elucidation of the mechanism of 2n megagametophyte formation will be of great help to optimize further sexual hybridization for polyploids in citrus.

To explore the clinical characteristics and prognosis of patients with angioimmunoblastic T cell lymphoma (AITL).The clinical features and prognostic factors of 42 cases newly diagnosed as AITL at Peking University Cancer Hospital from January 2007 to August 2012 were retrospectively analyzed.Their median age was 59(34-76) years. Among them, 97.6% cases (41/42) belonged to Ann Arbor stage III/IV, 73.8% (31/42) cases presented with B symptoms, 85.7% (36/42)cases had painless lymphadenopathy, 52.4% (22/42)cases extranodal involvement, 64.3% (27/42) cases elevated lactate dehydrogenase and 45.2% (19/42) cases elevated β2-microglobulin at diagnosis. And 40.5% (17/42) cases had 3 points of international prognostic index (IPI) score with the highest proportion.First-line chemotherapy was predominantly CHOP (cyclophosphamide, vincristine, doxorubicin, prednisolone) or CHOP-like-based and complete response was achieved in 44.7% (17/38) of them. The median follow-up time was 40 (2-106) months The 1, 2, 5-year survival rates were 78%, 57% and 39% respectively.Statistical analysis showed that IPI was an independent prognostic factor (P = 0.009).Other factors included gender (P = 0.311), age (P = 0.263), with or without B symptoms (P = 0.102), Ki-67 index (P = 0.146) as well as the choice of first-line chemotherapy (P = 0.292) each had a tendency of affecting; the survival rate, but failed to reach statistical significance.Angioimmunoblastic T-cell lymphoma is a major type of peripheral T-cell lymphoma. Most AITL patients are elders with a late stage. The disease generally displays an aggressive clinical course and poor prognosis.

To explore the clinical characteristics and prognosis of patients with primary testicular non-Hodgkin's lymphoma.The clinical profiles and prognostic factors of 21 cases newly diagnosed as primary testicular non-Hodgkin's lymphoma at Peking University Cancer Hospital from January 2005 to December 2012 were retrospectively analyzed.Their median age was 59 (34-86) years. And they were classified as Ann Arbor stage I (n = 8), stage II (n = 2) and stage IV (n = 11). There were B symptoms (n = 4), extranodal involvement outside testis (n = 12) and elevated lactate dehydrogenase (LDH) at diagnosis (n = 6). The scores of international prognostic index (IPI) were 0-1 point (n = 10), 3 points (n = 10) and 4 points (n = 1). The regimens included orchidectomy as the initial treatment (n = 15), chemotherapy followed by radiotherapy (n = 7) and CNS prophylaxis during treatment (n = 15). All patients were pathologically diagnosed as diffuse large B-cell lymphoma. And 11 cases belonged to the non-germinal center B cell-like subgroup.First-line chemotherapy was either R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone) or CHOP-like-based regimen. Complete response was achieved in 85.7% of patients. The median follow-up period was 18 (6-58) months. The 1, 2 and 3-year survival rates were 100%, 80% and 60% respectively. Statistical analysis showed that the first-line chemotherapy with rituximab was a prognostic factor (P = 0.038).Other factors included stage (P = 0.275), LDH level (P = 0.179) , β2-microglobulin level (P = 0.229) and IPI (P = 0.275) .The prognosis of primary testicular non-Hodgkin's lymphoma is usually poor. The first-line chemotherapy with rituximab is a prognostic factor.

Background Primary cutaneous lymphoma (PCL) comprises a heterogeneous group of diseases in regard to clinical presentation, histologic appearance, and biological behavior. Its rare occurrence limits analysis of disease features and survival of patients. Patients and Methods All patients with PCL treated in our hospital during January 2006 to October 2012 were included in this retrospective study. Their histologic and clinical data were analyzed. The diagnosis of PCL and the evaluation of clinical behavior were based on the 2005 World Health Organization–European Organisation for Research and Treatment of Cancer (WHO-EORTC) classification. Results Fifty-four cases of PCL were included in the study. The median age was 52.5 years. Thirteen (24.1%) patients had B-cell lymphoma and 41 (75.9%) had T-cell lymphoma. Twenty-nine (53.7%) patients exhibited disease having indolent clinical behavior, 14 (25.9%) presented with B symptoms, and 16 (29.6%) had elevated lactate dehydrogenase (LDH) levels at baseline. Within a median follow-up of 47.8 months, the expected 5-year progression-free survival (PFS) rate and overall survival (OS) rate were 6% and 14%, respectively. Using multivariate analysis, aggressive behavior (hazard ratio [HR], 2.92; P = .01] and elevated LDH levels at baseline (HR, 2.88; P = .01) were identified as independent risk factors for PFS. In addition, aggressive behavior (HR, 4.09; P = .01) and elevated LDH levels at baseline (HR, 3.69; P = .01) were also identified as independent risk factors for OS. Conclusion The study data suggest that aggressive behavior and elevated LDH levels at baseline were predictive factors for poor PFS and OS, which supports the need for immediate treatment of those patients.

To evaluate the value of (18)F-FDG PET/CT in detecting residual disease and predicting relapse following first-line treatment in patients with diffuse large B cell lymphoma (DLBCL).The clinical data of 39 patients with DLBCL, who underwent PET/CT scan after first-line treatment, were analyzed retrospectively. Kaplan-Meier method was used to analyze the survival of patients.PET/CT findings were interpreted as negative, mild metabolism and positive. Seventeen patients' PET/CT findings were judged as negative, none of them relapsed with a median follow-up of 24.1 months, 13 were judged as mild metabolism, 2 of them relapsed with a median follow-up of 17.1 months. Of the rest 9 findings were judged as positive with a median follow-up of 16.3 months, 4 patients were considered as disease progression according to clinical manifestations and other radiographic results, 2 patients relapsed at the time points of 13.5 and 6.8 months after PET/CT scan respectively, the other 3 patients were diagnosed as negative by biopsy, none of them relapsed at the time points of 5.9, 9.6 and 20.0 months after PET/CT scan respectively. One-year progression-free-survival (PFS) for negative, mild metabolism and positive groups was 100%, 83% and 56%, respectively. Two-year PFS was 100%, 83% and 42%, respectively. Overall survival (OS) at 1 year for negative, mild metabolism and positive groups was 100%, 100% and 89%, respectively. Two-year OS was 100%, 100% and 63%, respectively (P = 0.004).DLBCL patients with negative and mild metabolism PET/CT following first-line treatment had good prognosis, who needed no additional therapy. While patients with positive PET/CT had poor prognosis, those patients should receive biopsy before adjusting treatment regimen because of the high false-positive rate.

To analyze the safety and adverse event profiling of pegylated L-asparaginase (PEG-asp) combined chemotherapy in the treatment of lymphoma patients.The clinical data of 32 lymphoma patients on PEG-asp-based chemotherapy from January 2008 to March 2012 were retrospectively collected and analyzed.There were 22 males and 10 females with a median age of 40 years. They were diagnosed as NK/T cell lymphoma (n = 22) and lymphoblastic lymphoma (n = 10). The overall response rate was 71.9% (23/32). And complete remission was 40.6% (13/32) and partial remission 31.3% (10/32). Myelosuppression was the most common adverse event at an incidence of 81.2% (26/32). Other adverse events included a low level of fibrinogen (n = 13, 40.6%), hypoalbuminemia (n = 8, 25%) and hyperlipidemia (n = 9, 28.1%). No instance of anaphylaxis, acute pancreatitis and thrombosis occurred.PEG-asp is both effective and safe in the treatment of lymphoma and it is well-tolerated.

To evaluate the prognostic value of maximum standard uptake (SUVmax) on pretreatment (18)F-fluoro-2-deoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) scan in patients with newly diagnosed diffuse large B cell lymphoma (DLBCL).The clinical data of 39 DLBCL patients undergoing a PET/CT scan at pre-treatment from December 2009 to October 2011 were analyzed retrospectively. SUVmax on PET/CT was evaluated by SPSS 13.0 for the associations with patient characteristics, prognostic factors, treatment efficacy and survival time.The median SUVmax was higher in non-germinal center B cell-like (non-GCB) patients than that in GCB ones (18.0(2.2 - 40.5) vs 11.6 (5.3 - 18.7), P = 0.039). No difference of SUVmax was observed between the patients with and without bulky disease (P = 0.539). SUVmax was not associated with such patient characteristics as international protein index, age, stage, Eastern Cooperative Oncology Group performance status, lactate dehydrogenase, number of extranodal involvement and Ki-67 (all P0.05). No significant difference in median SUVmax existed between complete remission (CR) and non-CR patients (P = 0.312). The difference of SUVmax was insignificant for the patients with efficacy and no efficacy (P = 0.243). With the cut-off values of 10, 15, 20, the CR rate, response rate, 2-year progression-free survival (PFS) rate and 2-year overall survival (OS) rate were not different between the patients with SUVmax below and above cut-off value (all P0.05).The prognostic value of SUVmax on PET/CT is indeterminate. And it can not be used to predict the patient prognosis.

Crude oil destined for Philadelphia-area refineries is transferred to lighters from the tankers in Delaware Bay because the channel in the Delaware River is too shallow for fully loaded tankers. We developed a simulation model for studying the effects of various policies on service levels. The results were used by Maritrans, the provider of the lightering services, and its largest customer to examine ways in which they could improve their working relationship. Although the customer valued Maritrans' services, it was considering alternative lightering solutions and most seriously considering doing its own lightering. The results of the model provided a deeper understanding of the role of lightering in the customer's crude-oil logistics system, showing that acquiring a separate fleet would be costly and allowing both parties to evaluate other alternatives for reducing costs and improving response times.

To analyze the status of hepatitis B virus (HBV) infection in non-Hodgkin lymphoma (NHL) patients.The serum HBV markers in NHL patients were detected by enzyme-linked immunosorbent assay (ELISA). The infection rate of HBV in NHL patients was compared with that in nationwide general population.The positive rates of HBsAg, anti-HBs and anti-HBc in 405 cases of NHL were 11.6%, 39.8% and 47.9%, respectively, which were statistically different from those in general population (P0.01). The positive rates of HBsAg, anti-HBs and anti-HBc in B-cell NHL and T-cell NHL were 13.3% vs 7.1% (P = 0.083), 40.6% vs 37.5% (P = 0.567), 53.2% vs 33.9% (P = 0. 001), respectively. The HBV DNA positive rate was 23.7% in 93 cases of NHL, and was 50.0% in 38 cases of HBsAg-positive NHL while 5.5% in 55 cases of HBsAg-negative but HBcAb-positive NHL.The infection rate of HBV in NHL patients is higher than that in general population, in which occult hepatitis B virus infection can not be ignored. The positive rate of anti-HBc in B-cell NHL is significantly higher than that in T-cell NHL. For NHL patients infected with HBV, prophylactic anti-HBV therapy to prevent viral reactivation should be given before the anti-cancer treatment. Further study in the relationship between HBV and NHL should be carried out in the future.

The objective of this study was to detect the expression levels of VEGF-C, VEGF-D, VEGFR-2 and VEGFR-3 in plasma of newly diagnosed lymphoma patients, and analyze their possible relationships with clinicopathological characteristics and prognosis. The expression levels of VEGF-C, VEGF-D, VEGFR-2 and VEGFR-3 in plasma from 86 newly diagnosed lymphoma patients were detected by enzyme-linked immunosorbent assay (ELISA). As a results, the multivariate analysis showed that VEGF-C level in non-Hodgkin's lymphoma patients was low, but high in Hodgkin's lymphoma patients; VEGFR-2 level was higher in patients60 years, while VEGF-D level was lower in patients with IPI2. The univariate analysis showed that VEGF-D level was lower in patients with IPI2, while VEGF-D and VEGF-C levels were higher in patients without B symptoms. Relationship analysis between these factors indicated that the relation of VEGF-D expression level with VEGFR-2 and VEGFR-3 was positive. It is concluded that VEGF-C, VEGF-D, VEGFR-2 and VEGFR-3 play important roles in the pathogenesis of lymphoma, and may be used as indicators of prognosis evaluation or even guide for the antiangiogenesis treatment of lymphoma.

To explore the clinical features, diagnosis, treatment and prognosis of central nervous system lymphoma (CNSL).Retrospective analysis was conducted for 31 CNSL cases from January 2007 to December 2009 in our hospital. Their clinical data were analyzed by statistical software package SPSS 16.0.Accounting for around 4.7% of all lymphomas at our institution, the present cohort had 21 males and 10 females with a median age of 38 years old. The major clinical manifestations were focal neurological deficits associated with the site of disease or increased intracranial pressure. Most patients were treated with chemotherapy-based regimens. The overall response rate was 67.7% (21/31) with 32.3% (10/31) complete remission rate (CR) and 35.5% (11/31) partial remission rate (PR). Involvement outside CNS or bone marrow, high international prognostic index (IPI) and B symptoms had significant effects on the therapeutic efficacy (P0.05). The overall survival rates were 80.7%, 74.2%, 64.5% and 58.1% at 3, 6, 12, 24 months respectively. The median survival time was 22.5 months. Univariate analysis showed that the clinical efficacy had significant effects on the overall survival of patients (OR = 0.030, 95%CI: 0.003 - 0.270, P = 0.000).The prognosis of CNSL remains poor. New diagnostic tools and treatment modality need to be explored.

To establish a method to predict therapeutic effect of Rituximab and explore the feasibility and potential of IL-2 improving antitumor activity of Rituximab with upregulated antibody-dependent cellular cytotoxicity (ADCC) in patients with B-cell lymphoma.Eighteen B-cell lymphoma patients and 13 health volunteers entered the study. Peripheral blood mononuclear cells (PBMNC) were isolated as effector cells, and Daudi (Burkitt's lymphoma) cells as target cell, the cytotoxicity and ADCC mediated by Rituximab (10 microg/ml) of PBMNC at different E:T ratios were performed by standard 51Cr-release-assay in vitro with or without IL-2-activation. Flow cytometric analysis was performed to identify PBMNC phenotype with or without IL-2-activation.A marked decrease of cytotoxicity and Rituximab mediated ADCC in the patients as compared with that in health volunteers, the results being (5.80 +/- 1.16)%, (14.32 +/- 1.50)% and (14.29 +/- 1.68)%, (24.14 +/- 1.53)% (t = 3.693, P = 0.001 and t = 3.372, P = 0.003) respectively. The decrease was correlated with the therapeutic effect of Rituximab (r = 0.781, P0.05). The cytotoxicity and Rituximab mediated ADCC in the patients could be partly recovered after IL-2 activation from (5.80 +/- 1.16)%, (14.32 +/- 1.50)% to (15.43 +/- 2.62)%, (35.79 +/- 2.58)% (t = 3.35, P = 0.003 and t = 7.17, P0.001) respectively.It may be a useful method for predicting the effect of Rituximab in B-cell lymphoma patients to analyze the cytotoxicity and ADCC of their PBMNC. The impaired activity of PBMNC could be partly recovered when IL-2 was administered before the use of Rituximab.

To investigate the clinical characteristics of diffuse large B-cell lymphoma (DLBCL) and the factors affecting its prognosis.From 1994 to 2002, 138 patients with DLBCL were confirmed by morphological and immunohistochemical examination. Sex, age, clinical stage, performance status (PS), serum lactate dehydrogenase (LDH), number of extranodal lesions, treatment response, cycles of chemotherapy, B symptom, erythrocyte sedimentation rate (ESR), 5-year survival rate and median survival time (mST) were included as the analysis indeces.Lymph nodes were involved in 87.7% of the patients, and extranodal lesions were found in 60.1%. Five-year survival rate was 41.3% for the entire group. Age, stage, PS, serum LDH, number of extranodal lesions, international prognostic index (IPI) and remission rates were significantly correlated with overall survival (OS) and mST (P0.05), However, sex, chemotherapy cycles, B symptom, ESR were not related to OS and mST (P0.05). Age, stage, remission rates were identified as independent factors affecting the prognosis. Combination of surgery and chemotherapy was quite impressive in the prolongation of survival of patients with extranodal lesions and gastrointestinal lymphoma compared to those by chemotherapy alone.Age, stage, PS, serum LDH, number of extranodal lesions, IPI, chemotherapy cycles and remission rates are significant factors affecting the prognosis in DLBCL patients. Age less than 40 years or/= 65 years, Stage III-IV, partial remission or progressive disease are demonstrated as poor prognostic factors. Combined treatment is the strategy suggested for DLBCL patients with extranodal lesions.

Incidence of liver non-Hodgkin's lymphoma (NHL) is increasing. This study was to explore clinical features, diagnosis, treatment, and prognosis of liver NHL.Records of 45 patients with liver NHL treated in our hospital from Jan. 1998 to May 2002, 9.6% of all NHL patients treated in the same period, were retrospectively analyzed with statistic software package of SPSS10.0.Of 45 patients, 32 were male,and 13 were female, the median age was 50 years. Immunophenotyping revealed that 24 cases were T cell original, 19 were B cell original, and 2 were undefined. According to International Work Formulation (IWF), 92% of 45 patients belonged to intermediate-grade. Clinical features of liver NHL were presented with fever, jaundice, hepatosplenomegalia, and liver dysfunction. Combination treatment based on chemotherapy was the major therapy. Median survival time was 4 months, overall 1-, and 2-year survival rates were 22%, and 18%.Early diagnose liver NHL is difficult, its treatment effect and prognosis are poor, combination therapy should be given as early as possible.