Lymphoepithelioma-like cholangiocarcinoma:A mimic of hepatocellular carcinoma on imaging features

Primary lymphoepithelioma-like carcinoma in the liver is extremely rare. A few cases of lymphoepithelioma-like cholangiocarcinoma have been reported, but few radiologic features were described. We reviewed 23 cases of lymphoepithelioma-like cholangiocarcinoma reported between 1996 and 2014 and describe a rare case of a 35-year-old woman in our hospital who was diagnosed with lymphoepithelioma-like cholangiocarcinoma of the liver and was a hepatitis B carrier. The tumor(1.6 cm) in our patient appeared to be hypoechoic in sonographic images and hypodense in computed tomography(CT) images. In addition, it was homogeneous hypointense in T1-weighted magnetic resonance(MR) images(MRI) and hyperintense in T2-weighted MRI. Dynamic gadolinium-enhanced MRI showed typical image pattern of hepatocellular carcinoma(HCC). The patient underwent a laparoscopic left hepatic lobectomy, and the resected tumor consisted of well-differentiated glandular cells with extensive lymphocytic infiltration that were immunoreactive to CK(AE1/AE3), CD3, and CD20. In addition, the tumor was positive for Epstein-Barr virus-encoded RNA in situ hybridization. Finally, lymphoepithelioma-like cholangiocarcinoma was diagnosed. In previous studies, the incidence is highest among middle-aged people. Most tumors appeared to be hypodense with either hypovascular or hypervascular patterns in CT images. This case report is the first study to address sonography, CT, and MRI observations and delineate pathologic correlations. We suggest that the imaging pattern of lymphoepithelioma-like cholangiocarcinoma, either the typical cholangiocarcinoma pattern or a mimic of HCC, should be considered in the differential lists for HCC.

Gastrointestinal tract post-transplant lymphoproliferative disorder after liver transplantation

To the Editor:Post-transplant lymphoproliferative disorder（PTLD）is a rare and potentially fatal complication occurring after all types of solid organ transplantation.;PTLD accounts for 20%of all de novo post-transplant tumors.;The most important risk factors for PTLD are prolonged intense immunosuppression and Epstein-Barr virus（EBV）

STUDY ON THE EFFECT OF DNA REPAIR IN PERIPHERAL LYMPHOCYTES OF DIABETES MELLITUS

The purpose of this study is to check the effect ofDiabetes mellitus on DNA repair of peripheral lympho-cytes.With liquid scintillation counting,the valueof lymphocytes unscheduled ~3H-TdR incorporation in-dex in the aged patients with diabetes mellitus grou-

CHROMOSOMAL ABERRATIONS OF PERIPHERAL BLOOD LYMPHOCYTES OF WORKERS AT A SULPHURIC ACID FACTORY

The frequencies of chromosomal aberrationsof the peripheral blood lymphocytes from 40workers chronically exposed to sulphurdioxide (SO2) at a sulphuric acid factory inTaiyuan city,North China,were studied.It was shown that the mean frequencies ofchromosomal aberrations or lymphocytes

Gastric mucosa-associated lymphoid tissue lymphomas and Helicobacter pylori infection:A Colombian perspective

AIM:To assess the significance of chromosome translocation t(11;18)(q21;q21),B-cell lymphoma 10 (BCL-10) protein and Helicobacter pylori (H.pylori) infection in gastric mucosa-associated lymphoid tissue (MALT) lymphoma in Colombia.METHODS:Fifty cases of gastric MALT lymphoma and their respective post-treatment follow-up biopsies were examined to assess the presence of the translocation t(11;18)(q21;q21) as identified by fluorescence in situ hybridization;to detect protein expression patterns of BCL10 using immunohistochemistry;and for evaluation of tumor histology to determine the correlation of these factors and resistance to H.pylori eradication.RESULTS:Infection with H.pylori was confirmed in all cases of gastric MALT lymphoma in association with chronic gastritis.Bacterial eradication led to tumor regression in 66% of cases.The translocation t(11;18)(q21;q21) was not present in any of these cases,nor was there evidence of tumor transformation to diffuse large B-cell lymphoma.Thirty-four percent of the patients showed resistance to tumor regression,and within this group,7 cases,representing 14% of all those analyzed,were considered to be t(11;18)(q21;q21)-positive gastric MALT lymphomas.Protein expression of BCL10 in the nucleus was associated with the presence of translocation and treatment resistance.Cases that were considered unresponsive to therapy were histologically characterized by the presence of homogeneous tumor cells and a lack of plasmacytic differentiation.Responder cases exhibited higher cellular heterogeneity and a greater frequency of plasma cells.CONCLUSION:Both t(11;18)(q21;q21)-positive MALT lymphoma cases and those with nuclear BCL10 expression are considered resistant to H.pylori eradication.It is suggested that chronic antigenic stimulation is not a dominant event in resistant cases.

维持性腹膜透析患者外周血NLR PLR HGB水平变化及其与钙磷代谢异常和全因病死率的关系

目的:探究维持性腹膜透析患者外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、血红蛋白(HGB)水平变化及其与钙磷代谢异常和全因病死率的关系。方法:选取2019年3月至2022年6月收治的维持性腹膜透析患者206例,评估患者是否存在钙磷代谢异常,分为异常组和正常组,比较两组外周血NLR、PLR、HGB水平,分析NLR、PLR、HGB与血钙、血磷水平相关性;随访至2022年12月,以全因病死为终点事件,分为病死组和存活组,比较两组外周血NLR、PLR、HGB水平,并用受试者工作特征(ROC)曲线评价NLR、PLR、HGB对患者全因病死的预测价值。结果:异常组外周血NLR、PLR及血磷水平高于正常组,血钙水平低于正常组(P<0.05);但两组年龄、性别、文化程度、原发疾病、透析时间及外周血HGB水平的比较,差异无统计学意义(P>0.05)。维持性血液透析老年患者外周血NLR、PLR与血钙水平呈负相关,与血磷水平呈正相关(P<0.05);而HGB与血钙、血磷水平无明显相关性(P>0.05)。病死组透析时间长于存活组,外周血NLR、PLR及血磷水平高于存活组,血钙水平低于存活组(P<0.05);但两组年龄、性别、文化程度、原发疾病及外周血HGB水平的比较,差异无统计学意义(P>0.05)。ROC曲线分析结果显示,外周血NLR、PLR预测患者全因病死的曲线下面积(AUC)分别为0.777(95%CI:0.688~0.866)、0.781(95%CI:0.668~0.895)。结论:维持性腹膜透析患者钙磷代谢异常与外周血NLR、PLR水平相关,且上述指标对患者全因病死具有一定的预测价值。

The putative mechanism of lymphopenia in CoVID-19 patients

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and its variants have caused>5oo million confirmed cases and>6 million deaths.Apart from the common clinical manifestations,63% of admitted coronavirus disease 2019(COvID-19)patients had lymphopenia,increasingto 85% in patients with severe disease(Huang et al.,2020).

Potential contribution of increased soluble IL-2R to lymphopenia in COVID-19 patients

Since the outbreak of coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),more than 6 million cases are confirmed and over 300,000 cases are dead after infection.Dysfunction of immunity in COVID-19 patients has been considered as one of the fatal factors for patients,especially cytokine release syndrome and lymphopenia.1,2,3 The reduced number and increased exhaustion level of lymphocyte are associated with elevated inflammatory cytokines in COVID-19 patients.4,5 However,the mechanism of cytokine-induced lymphopenia in COVID-19 is very unclear.IL-2 is critical for the proliferation,differentiation,and function of T cells,including Tregs,CD4+,and CD8+effector cells.6 Here,we reported the negative relationship between the concentration of soluble IL-2 receptor(sIL-2R)and T-cell number in blood from COVID-19 patients.In vitro addition of recombinant CD25 could inhibit the proliferation and function of T cells from PBMC after stimulated with TCR signaling,which could be rescued by strong IL-2 signaling.Our data suggested the importance of IL-2 signaling in lymphopenia of COVID-19 patients.

Clinicopathological features and prognostic factors of 216 cases with primary gastrointestinal tract non-Hodgkin's lymphoma

Objective To investigate the clinicopathological features of primary gastrointestinal non-Hodgkin’s lymphomas (PGI-NHL) and their prognostic values.Methods The clinical and pathological data of 216 patients diagnosed as PGI-NHL from Zhejiang Cancer Hospital

The influence of microcystin-LR on monocytes and lymphocytes of mice

Objective To investigate the influence of microcystin-LR (MC-LR) on monocytes and lymphocytes in blood of mice and to find a sensitive index of toxic effects.Methods Specific pathogen free Kunming male mice,aging 1 month-old,were randomly divided into 5 groups

Effect of cisplatin alone or combined with monoclonal anti-programmed death ligand-1 anti-body on lung adenocarcinoma cell line SPCA-1 and T lymphocytes

Objective To observe the effect of cisplatin alone or combined with anti-programmed death ligand 1 monoclonal antibody(anti-PD-L1 mA b)on the co-culture system of lung adenocarcinoma SPCA-1 cells and T lymphocytes,and therefore to study the immunotherapeutic effect of anti-PD-L1 mA b on lung cancer.Methods Human adenocarcinoma SPCA-1 cell line was selected

GNRI联合NLR对老年髋部骨折患者术后谵妄的预测价值

目的探讨老年营养风险指数(GNRI)联合中性粒细胞/淋巴细胞(NLR)对老年髋部骨折患者术后谵妄(POD)的预测价值。方法选择老年髋部骨折患者223例,均接受手术治疗,发生POD 51例(POD组)、未发生POD 172例(非POD组)。比较两组术前GNRI和NLR。收集老年髋部骨折患者术前基本资料、手术相关资料以及实验室检查资料,采用多因素Logistic回归模型分析老年髋部骨折患者发生POD的影响因素。采用受试者工作特征(ROC)曲线分析GNRI、NLR对老年髋部骨折患者POD的预测效能。结果POD组GNRI低于非POD组,NLR高于非POD组(P均<0.05)。多因素Logistic回归分析显示,年龄(OR=1.081,95%CI:1.019~1.146)、脑卒中(OR=2.712,95%CI:1.011~7.271)、NLR(OR=1.484,95%CI:1.021~2.156)为老年髋部骨折患者发生POD的独立危险因素(P均<0.05),而GNRI(OR=0.880,95%CI:0.825~0.940)则为其独立保护因素(P<0.05)。ROC曲线分析显示,GNRI、NLR单独和联合预测老年髋部骨折患者POD的曲线下面积(AUC)分别为0.755、0.746、0.824,GNRI联合NLR预测老年髋部骨折患者POD的AUC高于二者单独(Z分别为2.676、2.607,P均<0.01)。结论GNRI联合NLR对老年髋部骨折患者POD具有较高的预测价值,可作为老年髋部骨折患者POD的预测指标。

临床特征联合CT影像组学列线图术前预测直肠癌脉管侵犯的价值

目的:探讨临床特征联合增强CT静脉期影像组学构建的列线图术前预测直肠癌脉管侵犯(LVI)的价值。方法:选取皖南医学院弋矶山医院2017年6月至2022年6月经组织病理学确诊的299例直肠癌患者为训练组,164例患者为验证组。根据LVI状态分为LVI阳性组与LVI阴性组。使用MaZda软件基于增强CT静脉期图像提取纹理特征,使用最小绝对收缩和选择算子(LASSO)回归对纹理特征进行降维,并建立影像组学标签,计算标签评分(Rad-score)。采用单因素及多因素Logistic回归分析筛选独立危险因素,建立预测LVI状态的模型,并绘制模型的列线图。使用受试者工作特征(ROC)曲线及曲线下面积(AUC)评价模型的区分度,使用Hosmer-Lemeshow检验及校准曲线评价模型的拟合优度及校准度,使用决策曲线(DCA)评价模型的临床适用性。结果:多因素Logistic回归分析发现癌胚抗原(CEA)、肿瘤分化程度及Radscore为独立危险因素,列线图在训练集AUC为0.811 (95%CI:0.760~0.861),验证集AUC为0.761 (95%CI:0.676~0.845)。Hosmer-Lemeshow检验结果,训练组(χ^(2)=7.981,P=0.435),验证组(χ^(2)=4.050,P=0.853),均无统计学意义。校准曲线显示列线图预测结果与实际情况一致性好。DCA表明该模型具有较高的临床适用性。结论:临床特征联合CT影像组学列线图术前预测直肠癌LVI状态具有较高的效能。

白细胞分离术在高白细胞急性白血病治疗中的应用现状

急性白血病患者周围血象中白细胞计数〉100×10~9/L时称为高白细胞急性白血病（hyperleukocyticacute leukemia,HAL）。HAL发病率占白血病总数的5%~26%,在急性淋巴细胞白血病（acute lympho-blastic leukemia,ALL）中发生率为10%~30%,急性髓细胞白血病（acute myeloid leukemia,AML）为5%~13%^（[1]）。因为白血病细胞的极度增生,

肺癌患者外周血T-淋巴细胞亚群NK细胞的基线数值及其与预后的关系

目的:对比肺癌患者与健康者之间淋巴细胞亚群差异,评估肺癌患者外周血T淋巴细胞亚群及自然杀伤细胞(NK)之基线值与预后的关系。方法:收集2006年2月至2013年3月就诊于天津医科大学肿瘤医院病例资料完整的肺癌患者105例,其中非小细胞肺癌(NSCLC)86例、小细胞肺癌(SCLC)19例,另选健康对照35例,对比接受治疗前肺癌患者和健康对照者外周血中的CD3+T细胞、CD4+T细胞、CD8+T细胞及NK细胞所占百分比,并回顾性分析86例NSCLC患者初治时外周血淋巴细胞亚群与预后的关系。结果:肺癌患者外周血CD3+T细胞、CD4+T细胞、NK细胞及CD4/CD8比值均明显低于健康对照组(P=0.011,P=0.007,P<0.001,P=0.025),而CD8+T细胞比例高于健康对照组(P=0.013)。当CD8+T≥31.8%及CD4/CD8<1.28时NSCLC患者可以获得一个更长的OS(中位OS分别为36.2 m vs.20.0 m,P=0.010;30.8 m vs.20.0 m,P=0.035)。而CD3+T细胞、CD4+T细胞及NK细胞百分比对NSCLC患者预后无显著影响。结论:外周血CD8+T细胞基线水平较高的NSCLC患者生存较长,此基线水平可能对NSCLC患者预后有指示作用。

NS复合乳酸菌制剂对断奶仔猪免疫水平的影响

选择二元杂交(杜/长)20日龄断奶仔猪90头,平均断奶体重8.99kg±1.60kg,按体重和性别分成3个处理组,每处理3个重复。A组为对照组,饲喂玉米、豆粕基础日粮;B组为基础日粮添加NS复合乳酸菌组2g/kg;C组为基础日粮添加抗生素组(2g/kg金霉素、0.25g/kg阿莫西林和0.125g/kg的支原净)。试验共30d,研究微生态制剂NS复合乳酸菌对断奶仔猪体液免疫和细胞免疫水平的影响。结果表明,试验30d时,NS复合乳酸菌组与对照组相比,断奶仔猪血清中的IgM含量和干扰素INF-γ的含量分别高出19.7%和10.2%,猪瘟病毒抗体阳性率高出33.3%,差异显著(P<0.05);与NS复合乳酸菌组相比,抗生素组仔猪外周血T细胞CD 8+亚群的比例要高出79.2%,差异显著(P<0.05)。NS复合乳酸菌制剂对加强仔猪体液免疫,维持仔猪的猪瘟、伪狂犬病毒抗体水平和促进机体细胞免疫具有良好效果。

瘤体内注射脂质体包裹的IL－2基因的抗肿瘤作用及其局部免疫机理分析

脂质体可以介导体内的细胞因子基因治疗。将脂质体包裹的ＩＬ－２基因直接注射到小鼠黑色素瘤（Ｂ１６－Ｆ１０）瘤体内，结果发现，肿瘤的生长明显受到抑制，部分小鼠的瘤体完全消退，存活期明显延长；从瘤体中分离的肿瘤细胞经Ｇ４１８筛选后产生阳性克隆，其上清中分泌有ＩＬ－２；肿瘤局部浸润性淋巴细胞（ＴＩＬ）具有较高的杀伤活性，揭示瘤体内注射脂质体包裹的ＩＬ－２基因后，可增强肿瘤细胞的免疫原性，激活瘤体局部的抗肿瘤免疫功能。结果表明瘤体内注射脂质体包裹的ＩＬ－２基因具有良好的抗肿瘤效果。

针刺对放、化疗患者免疫功能的调节作用

针刺曲池、合谷、足三里等穴，对恶性肿瘤放、化疗患者外周血Ｔ细胞及其亚群．血清ＩｇＧ、ＩｇＡ、ＩｇＭ含量及Ｃ３的调节作用。结果表明针刺能提高并调整放、化疗患者免疫功能，减轻放、化疗副作用。

单唾液酸四己糖神经节苷脂钠联合脑蛋白水解物对帕金森病患者血清指标及免疫应答的影响

目的:研究单唾液酸四己糖神经节苷脂钠联合脑蛋白水解物对帕金森病患者血清指标及免疫应答的影响。方法:选择2012年3月~2014年12月在我院确诊并接受治疗的94例帕金森病患者,随机分为接受单唾液酸四己糖神经节苷脂钠联合脑蛋白水解物治疗的观察组以及接受单唾液酸四己糖神经节苷脂钠单药治疗的对照组,测定外周血中CD4^+T淋巴细胞亚群的含量以及血清中细胞因子、神经损伤分子含量。结果:观察组外周血中CD4^+CD45RA^+原始T细胞、CD4^+CD25highFoxp3^+调节性T细胞的含量显著高于对照组(P<0.05),外周血中CD4^+CD45RO^+记忆T细胞的含量显著低于对照组(P<0.05);血清中干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)以及神经元特异性烯醇化酶(NSE)、S100β的含量显著低于对照组(P<0.05),血清中IL-4、IL-10以及β-淀粉样蛋白1-42(Aβ1-42)、脑源性神经营养因子(BDNF)的含量显著高于对照组(P<0.05)。结论:单唾液酸四己糖神经节苷脂钠联合脑蛋白水解物治疗PD能够调节免疫功能、减轻神经元的炎症损伤和免疫损伤。

苏南地区部分饮用水源水的有机污染物研究

以美国EPA建议的多污染物分析与评价系统,对苏南地区部分饮用水源水质的危险度进行了评价。评价结果各水样健康危险度均>1,表明各水样对人健康均存在潜在危害,而生态风险度均<1。同时,采用人外周血淋巴细胞彗星试验,对各水样有机浓集物的生物毒性进行了研究,结果表明水样浓集物可对淋巴细胞DNA产生不同程度的损伤,存在一定的遗传毒性。试验结果与水质状况基本一致,表明上述两种方法对于评价水体有机物污染的有效性。