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Objective: To explore the clinical features and survival of newly diagnosed follicular lymphoma (FL) patients with diffuse large B-cell lymphoma (DLBCL) component. Methods: 1845 newly diagnosed FL patients aged ≥ 18 years with grades 1-3a in 11 medical centers in China from 2000 to 2020 were included, and patients with DLBCL component were screened. The clinical data and survival data of the patients were retrospectively analyzed, and the prognostic factors were screened by univariate and multivariate analysis. Results: 146 patients (7.9% ) with newly diagnosed FL had DLBCL component. The median age was 56 (25-83) years, 79 males (54.1% ) . The pathology of 127 patients showed the proportion of DLBCL component. Patients were divided into two groups according to whether the proportion of DLBCL component was ≥ 50% . The study found that patients with DLBCL component ≥ 50% had higher grade 3 ratio (94.3% vs 91.9% , P =0.010) , Ki-67 index ≥ 70% ratio (58.5% vs 32.9% , P =0.013) and PET-CT SUVmax ≥ 13 ratio (72.4% vs 46.3% , P =0.030) than patients with DLBCL component<50% . All patients received CHOP or CHOP like ± rituximab chemotherapy. The overall response rate (ORR) was 88.2% , and the complete response (CR) rate was 76.4% . In the groups with different proportions of DLBCL component, there was no significant difference in the remission rate after induction treatment and the incidence of disease progression within 2 years after initiation of treatment (POD24) ( P <0.05) . The overall estimated 5-year progression free survival (PFS) rate was 58.9% , and the 5-year overall survival (OS) rate was 90.4% . The 5-year OS rate of POD24 patients was lower than that of non POD24 patients (70.3% vs 98.5% , P <0.001) . Compared with non maintenance treatment of rituximab, maintenance treatment of rituximab could not benefit the 5-year PFS rate (57.7% vs 58.8% , P =0.543) , and the 5-year OS rate had a benefit trend, but the difference was not statistically significant (100% vs 87.8% , P =0.082) . Multivariate analysis showed that failure to reach CR after induction treatment was an independent risk factor for PFS ( P =0.006) , while LDH higher than normal was an independent risk factor for OS ( P =0.031) . Conclusion: FL patients with DLBCL component ≥50% have more invasive clinical and pathological features. CHOP/CHOP like ± rituximab regimen can improve the clinical efficacy of patients. Rituximab maintenance therapy can not benefit the PFS and OS of patients. Failure to reach CR after induction therapy was the independent unfavorable factor for PFS.

Objective: To study the effect of death decoy receptor 3 on the prognosis of breast cancer and the invasive function of breast cancer cells in vitro . Methods: Expression of DcR3 were assessed qualitatively by Q-PCR to analyze the correlation in 115 mammary tissue samples with a 10-year median follow-up. The expression of DcR3 was examined in MCF7 and MDA-MB-231 cell lines using immunocytochemical staining and RT-PCR. DcR3 knock-down cell sub-lines were constructed. The effects of reduced DcR3 expression were observed by establishing invasion and migration models. Results: Patients were divided into the good prognosis group ( n= 81) and the poor prognosis group ( n= 26). The expression of DcR3 in the poor prognosis group (133 350+49 646 copies/50 ng RNA)was significantly higher than that in the good prognosis group (5 393+1 428 copies/50 ng RNA, P= 0.020). DcR3 transcripts were found to be increased significantly in grade 2 cancers compared to well differentiated grade 1(82 844±34 068 copies/50 ng RNA, n= 39,) vs (5 371±3 500 copies/50 ng RNA, n= 20, P= 0.029).The DcR3 gene of MCF7 cell line and MDA-MB-231 cell line were successfully knocked out and verified that DcR3 knockout. And the invasion and migration of MCF7 cells were inhibited ( P= 0.009, P= 0.001). However, no significant difference was found in these two aspects of the MDA-MB-231 cell line ( P= 0.475, P= 0.102). Conclusion: DcR3 promotes the capacity of invasion of breast cancer cells and plays an important role in the metastasis of breast cancer. DcR3 detection is helpful to the judgment about prognosis of breast cancer.

Factors correlated to the motivation for rehabilitation in stroke patients were studied. Thirty patients who had had only one stroke were recruited between December 1991 and April 1992 for our study. Several assessment tools including the Motivational scale, the Health Locus of Control scale and a questionnaire were used. According to the results of the assessment, the stroke patients' motivation remained stable when assessed two to three times during the hospital stay, whereas their UE/LE Brunnstrom stage scores and activities of daily living skill (ADL) improved significantly. The motivation of the patients was closely correlated with the degree of education, the internal scores and ADL performance: patients with education level higher than primary school, higher internal scores, or better ADL performance had stronger motivation for rehabilitation. On the other hand, motivational assessments between the nursing staff and the therapists were not completely in agreement. The ADL performance was better correlated with the degree of motivation on the nursing assessment, whereas the Brunnstrom stage scores of UE/LE were more closely correlated with the therapists' assessment. Items on the motivational questionnaire such as "eagerness to recover earlier", "recognition of the effectiveness of rehabilitation", "support of spouse" and "homesickness" were commonly considered to be positive factors. However, the other factors such as "being in bad mood", "lack of family cooperation", "worrying about things other than finances" and "lack of family support" were commonly considered to be negative factors on motivation. In the comparison between high and low motivation groups, the high motivation group payed more attention to the positive factors such as "eagerness to be independent" and such negative factors as "lack of understanding of illness" as well as "poor appetite and fatigue". The low motivation group was considered to be more affected by such negative factors as "worrying about things other than finances", "not good enough facilities" and "homesickness" which resulted in lessening the motivation for rehabilitation.

128 acromegaly patients were followed up for 1-23 years (mean 5.9 +/- 5.0 years) after external pituitary irradiation; among them 104 patients received fractional irradiation with an ultimate total dose of 4000-5000 rad. The remaining patients received a total dose of either < 4000 rad or > 5000 rad. Human growth hormone (hGH) level was measured after an oral load of 100g glucose to evaluate the effect of irradiation. After external pituitary irradiation, the serum level of hGH decreased progressively. The decrease was more rapid in the first three years with a decrement of 35.1% per year. 36.2% of all the patients has been judged as clinically inactive with low serum hGH level of < or = 5 ng/ml. 62.1% of the patients was considered as slightly active with hGH level < or = 10 ng/ml in the 15th year after therapy. The effect of irradiation was not influenced by the age of the patients, the course of acromegaly, the size of sella turcica and operation prior to irradiation. If the total dose of irradiation is lower than 4000 rad, the effect will not be good.