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脾脏IgG4相关性疾病（IgG4-related disease，IgG4-RD）极为罕见。本文报道1例以脾脏肿块为主要表现的IgG4-RD病例，并进行相关文献复习，提示脾脏可以发生IgG4-RD。推荐对于脾脏不明原因占位的术前筛查应包括血清IgG4 和相关免疫指标。针对糖尿病并发IgG4-RD的患者，艾拉莫德有潜力成为替代糖皮质激素的药物。.

目的 分析遗传性凝血因子Ⅺ（FⅪ）缺乏症的临床表现、实验室检查、治疗及转归。 方法 对2006年9月至2020年10月就诊于中国医学科学院血液病医院的80例遗传性FⅪ缺乏症患者进行回顾性分析。结果 80例患者中，男33例（41.3％），女47例（58.8％），中位年龄32（2～66）岁。28例（35.0％）存在出血事件，其中自发性出血11例（13.8％），皮肤磕碰后瘀斑或出血9例（11.3％），手术后出血9例（11.3％），女性患者月经过多11例（23.4％），阴道分娩后出血1例（2.1％）。实验室检查表现为活化部分凝血活酶时间（APTT）延长、凝血酶原时间（PT）正常、FⅪ活性（FⅪ∶C）减低。9例（11.3％）患者接受F11基因检测，共检测到11种突变。27例（33.8％）患者接受新鲜冰冻血浆（FFP）治疗，15例（18.8％）手术前预防性输注患者均未发生术中、术后出血。 结论 多数遗传性FⅪ缺乏症患者无出血症状或症状轻微，FⅪ∶C与出血严重程度之间缺乏相关性，FⅪ∶C与F11基因纯合或杂合突变类型具有较好的一致性。预防性输注FFP可有效降低手术出血风险。

This present study aimed to compare the treatment response, survival profile, quality of life (QoL), and safety between drug-eluting bead bronchial arterial chemoembolization (DEB-BACE) and chemotherapy in the treatment of advanced non-small-cell lung cancer (NSCLC).Totally, 44 advanced NSCLC patients were analyzed retrospectively and were divided into DEB-BACE group (n=23) and chemotherapy group (n=21). Treatment response, European Organization for Research and Treatment of Cancer QoL Questionnaire-Core 30 (EORTC QLQ-C30), progression-free survival (PFS), overall survival (OS), and adverse events were assessed during the follow-up.At month (M) 2, M4 and M6 post initial treatment, objective response rate (ORR) was elevated (all p0.05), and disease control rate (DCR) tended to be higher (without statistical significance) in DEB-BACE group compared with chemotherapy group. Regarding the QLQ-C30 item scores, the scores of physical functioning, role functioning, emotional functioning, cognitive functioning, social functioning were increased, while the scores of nausea and vomiting, dyspnea, constipation were decreased in DEB-BACE group compared with chemotherapy group (all p0.05). Based on survival profile, DEB-BACE group achieved better PFS and OS compared with chemotherapy group independent of TNM stage, which was also supported by further subgroup analysis and Cox's proportional hazard regression analysis (all p0.05). Furthermore, two groups all exhibited mild and tolerable adverse events.DEB-BACE has the potential to be an additional treatment option with favorable therapeutic efficacy, improved QoL, and tolerable safety for advanced NSCLC patients.

There is controversy regarding the role of palliative gastrectomy in patients with incurable advanced gastric cancer requiring surgical intervention. The present retrospective cohort study and meta-analysis aimed to determine whether palliative gastrectomy plus chemotherapy can prolong the survival of patients with incurable advanced gastric cancer requiring surgical intervention.The data from 153 patients diagnosed with incurable advanced gastric cancer requiring surgical intervention at our institute between January 2000 and December 2012 were retrospectively reviewed. We analyzed the value of palliative gastrectomy and identified the potential prognostic factors. We also conducted a meta-analysis of 10 studies to validate our results.Multivariate analysis indicated that palliative gastrectomy was a favorable independent prognostic factor for prolonged overall survival in incurable advanced gastric cancer patients requiring surgical intervention (p=0.029). The median survival of patients who underwent palliative gastrectomy plus chemotherapy was significantly longer than that of those who underwent non-resection surgery plus chemotherapy (12 months vs. 9 months, p=0.020). The patients in the non-resection surgery plus chemotherapy group exhibited significantly shorter overall survival than those in the D1+ lymphadenectomy group, D2 lymphadenectomy group, or distal gastrectomy group (p=0.021, p=0.007, and p=0.006, respectively). Our meta-analysis revealed that gastrectomy plus chemotherapy improved long-term survival in incurable advanced gastric cancer patients (hazard ratio (HR): 0.48; 95% confidence interval (CI): 0.35-0.67; p0.001).Palliative gastrectomy plus chemotherapy may improve overall patient survival compared with non-resection operations plus chemotherapy in incurable advanced gastric cancer patients requiring surgical intervention.

Long-chain non-coding RNA (LncRNA) is abnormally expressed in various malignant tumors. In recent years, it has been found that the expression of LncRNA SNHG6 is upregulated in gallbladder carcinoma tissues, which participated in the occurrence and development of gallbladder carcinoma. However, the clinical value of SNHG6 in gallbladder cancer serum is not clear, and there are few studies regulating the biological function of gallbladder carcinoma cells. This study aimed to investigate LncRNA SNHG6 and miR-26b-5p in gallbladder carcinoma and its related mechanisms.From February 2017 to February 2019, altogether 68 cases of gallbladder cancer patients admitted to the Yantai Yeda Hospital were collected as a study group, 70 healthy people as a control group. Gallbladder cancer cells and human colorectal mucosa cells were purchased. Sh-SNHG6, si-SNHG6, NC, miR-26b-5p-inhibitor, and miR-26b-5p-mimics were transfected into GBC-SD and NOZ cells. For the detection of SNHG6 and miR-26b-5p in samples we used qRT-PCR, WB was applied for the decreased protein expression of Gli1, Gli2, Shh, Smo, N-cadherin, vimentin, Snail, E-Cadherin, and Gli3 in cells. MTT assay was applied for the detection of cell proliferation, transwell assay for cell invasion, and flow cytometry assay for apoptosis.SNHG6 was highly expressed in gallbladder carcinoma, miR-26b-5p was downregulated, and the area under curve (AUC) of LncRNA SNHG6 and miR-26b-5p was more than 0.8. LncRNA SNHG6 and miR-26b-5p were related to age, sex, tumor invasion, differentiation degree, tumor location, and tumor-node-metastasis (TNM) staging of gallbladder cancer patients. Silencing of SNHG6 and upregulation of miR-26b-5p could promote cell apoptosis, inhibit cell growth, and epithelial-mesenchymal transition (ETM). Silencing of SNHG6 and upregulation of miR-26b-5p could inhibit Gli1, Gli2, Shh, Smo, N-cadherin, vimentin and Snail proteins, and promote upregulation of Gli3 and E-Cadherin expression. Dual-Luciferase report confirmed that SNHG6 and miR-26b-5p have targeted relationship. Rescue experiments showed that after co-transfecting sh-SNHG6+miR-26b-5p-mimics, and si-SNHG6+miR-26b-5p-inhibitor into GBC-SD and NOZ, the proliferation, invasion and apoptosis of cells were not different from those of miR-NC group without transfection sequence.Inhibition of LncRNA SNHG6 expression can upregulate miR-26b-5p mediated Hedgehog signaling pathway, affect epithelial-mesenchymal transition, proliferation and invasion of cells, so LncRNA SNHG6is hoped to be a latent therapeutic target for gallbladder carcinoma.

OBJECTIVE: To validate five-year risk prediction models for stroke in a contemporary rural Northern Chinese population. METHODS: Totally 6 483 rural adults aged 40 to 79 years without cardiovascular diseases were enrolled at baseline between June and August 2010, and followed up through January 2017. Expected prediction risk using the China-PAR (prediction for atherosclerotic cardiovascular disease risk in China) stroke risk equations were compared with the new Framingham stroke risk profile (FSRP). The recalibrated models were applied by adjusting the five-year baseline survival rate and the mean score to our rural northern Chinese population, while keeping other coefficient parameters the same as the original models. Kaplan-Meier analysis was used to obtain the observed event (nonfatal or fatal stroke) rate for the five years, and the expected-observed ratios were calculated to evaluate overestimation or underestimation in the cohort. The models were assessed by discrimination C statistic, calibration χ(2), and calibration charts and plots for illustration as well. RESULTS: Over an average of (5.83 ± 1.14) years of the follow-up in this validation cohort with 6 483 rural Chinese participants, 438 subjects deve-loped a first stroke event. Recalibrated China-PAR stroke risk equations and FSRP well-performed for predicting five-year stroke risk in men, and had C statistics of 0.709 (95%CI, 0.675 - 0.743) and 0.721 (95%CI, 0.688 - 0.754), with calibration χ(2) values being 5.7 (P = 0.770) and 13.6 (P = 0.137), respectively. However, both China-PAR and FSRP overestimated stroke events by 11.6% and 30.0% in women, and had C statistics of 0.713 (95%CI, 0.684-0.743) and 0.710 (95%CI, 0.679-0.740), respectively. Calibration χ(2) values in women were 12.5 (P = 0.188) for China-PAR and 24.0 (P = 0.004) for FSRP. In addition, the calibration charts and plots illustrated good agreement between the observations and the predictions only in the China-PAR stroke risk equations, especially for men. CONCLUSION: In this validation cohort of rural northern Chinese adults, the China-PAR models had better performance of five-year stroke risk prediction than the FSRP, indicating that recalibrated China-PAR stroke risk equations might be appropriate tools for risk assessment and primary prevention of stroke in China.

目的 分析原发性血小板增多症（ET）患者基因突变谱及临床特征。 方法 对2009年2月1日至2018年11月1日收治的178例初诊ET患者进行回顾性分析。 结果 全部178例患者中，男89例，女89例，中位初诊年龄为49.5（3~86）岁。JAK2V617F基因突变频率为16.45%（1.67%~43.90%），CALR基因突变频率为40.00%（10.00%~49.15%），MPL基因突变频率为25.10%（25.00%~40.00%）。与CALR基因突变的患者相比，JAK2V617F基因突变患者具有较高的发病年龄（P=0.035）、初诊白细胞计数（P=0.040）、初诊血红蛋白浓度（P=0.001）和较低的初诊血小板计数（P=0.002）。47例（27.01%）患者诊断ET前发生血栓事件，3例（1.72%）诊断ET后发生血栓事件。多因素分析结果显示，年龄>60岁（P=0.013，OR=4.595，95%CI1.382~15.282）、心血管危险因素（P60岁（P=0.042，OR=4.045，95%CI1.053~15.534）是影响ET患者总生存时间的危险因素。年龄≤60岁、年龄>60岁患者的OS时间分别为（115.231±1.899）、（83.291±4.991）个月（χ2=6.406，P=0.011）。 结论 心血管危险因素、年龄>60岁为ET患者血栓事件的危险因素，CALR基因突变为血栓事件的保护性因素。年龄>60岁是影响ET患者总生存的危险因素。

目的 探索2017年版中国DIC诊断积分系统（CDSS）在急性早幼粒细胞白血病（APL）DIC诊断中的适用性。 方法 回顾性分析2004年1月至2018年2月就诊于中国医学科学院血液病医院并行诱导治疗的220例APL患者病历资料，采用CDSS、国际血栓与止血协会（ISTH）DIC积分系统和日本卫生福利部（JMHW）DIC积分系统分别进行评价及比较分析。 结果 220例APL患者中，男114例，女106例，中位年龄38.5（12~70）岁，其中低/中危组173例，高危组47例。11例患者诱导治疗期死亡。CDSS、ISTH、JMHW三种标准诊断DIC阳性率分别为62.27%、54.09%、69.09%。CDSS和ISTH诊断DIC的一致率为78.10%，CDSS和JMHW诊断DIC的一致率为88.32%。ROC曲线比较三者互为参照的敏感度及特异度，敏感度JMHW>CDSS>ISTH，特异度ISTH>CDSS>JMHW。CDSS DIC（+）和DIC（−）组患者PT、APTT、纤维蛋白原（FIB）、D-二聚体及纤维蛋白原/纤维蛋白降解产物（FDP）之间差异均有统计学意义（P值均0.05）；单因素Logistic回归显示患者起病时WBC、骨髓中异常早幼粒细胞比例对DIC的发生存在影响（P3×109/L是DIC发生的独立危险因素（OR=3.525，95%CI 1.875~6.629，P

目的 观察艾曲泊帕治疗成人慢性原发免疫性血小板减少症（ITP）的疗效及安全性。 方法 2013年1月29日至2014年5月16日，纳入35例慢性ITP患者进行随机、双盲、安慰剂对照临床研究，以25 mg/d为起始剂量给予艾曲泊帕（17例）或安慰剂（18例），疗程为6周。 结果 35例慢性ITP患者中男6例、女29例，中位年龄42（22~66）岁。艾曲泊帕组退组1例，其余患者均完成治疗。艾曲泊帕组在治疗开始2周内PLT≥30×109/L的患者百分比高于安慰剂组[64.71%（11/17）对27.78%（5/18），P=0.031]。治疗第6周，艾曲泊帕组PLT≥50×109/L、PLT≥30×109/L患者百分比均高于安慰剂组[64.71%（11/17）对11.11%（2/18），P=0.001；76.47%（13/17）对38.89%（7/18），P=0.028]。艾曲泊帕组6周治疗期内至少1次PLT≥50×109/L、50%时间PLT≥50×109/L的患者百分比均高于安慰剂组[94.11%（16/17）对33.33%（6/18），P

To explore the relationship between glycemic control and visceral adiposity index (VAI) among type 2 diabetes mellitus (T2DM) patients.A community-based epidemiological field study for patients with T2DM aged ≥ 40 years was conducted in China.Every participant underwent physical examinations, biochemical tests of fasting glucose, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and so on, and a questionnaire, including anthropometric characteristics, lifestyle, disease history, family history, and medication use. Those participants with HbA1c ≥7.0% were classified as the poorly controlled in our analysis of relationship between glycemic control and VAI. Anthropometric characteristics, lifestyle, and biochemical indexes of the participants were compared among the groups of different VAI levels. Logistic models were applied in multiple analysis adjusting for possible confounders.A total of 1 607 patients with T2DM were recruited in our analysis with a mean age of (59.4±8.1) years and an average T2DM duration of (7.0±6.4) years. Among them, 78.3% were on hypoglycemic therapy. The cutoff points of quartiles of VAI were calculated for the males and females, respectively. According to the ascending order of the quartiles of VAI, the participants were divided into four groups, i.e. Q1, Q2, Q3, and Q4. The poor glycemic control rate for these groups were 60.6%, 65.7%, 70.1%, and 71.0%, respectively (Trend χThe glycemic control among the patients with T2DM is significantly associated with VAI. High level of VAI is an indicator of poor glycemic control.

目的 评估修订版国际血栓预测模型（IPSET）在中国原发性血小板增多症（ET）患者中的应用价值，探索适用于中国ET患者的血栓预测模型。 方法 对1982年3月1日至2012年4月30日期间诊治的746例成人ET患者的病历资料进行回顾性分析。 结果 全部746例患者中，男305例，女441例，诊断时中位年龄52（18~87）岁。采用修订版IPSET将患者分组，其中极低危组271例（36.3%）、低危组223例（29.9%）、中危组63例（8.4%）、高危组189例（25.3%），四组的无血栓生存差异有统计学意义（χ2=72.301，P

The aim of this study was to screen miRNAs related to different subtypes of breast cancer and their target genes to identify new markers of tumor subtype.The miRNA expression profiles of breast cancer GSE38867 including 7 ductal carcinoma in situ breast (DCIS) cancer samples, 7 invasive breast cancer samples, 7 metastatic breast cancer samples, and 7 normal breast samples) were downloaded from Gene Expression Omnibus (GEO) database. Limma package in R software was applied to identify specific differentially expressed miRNAs of different subtypes of breast cancer. MicroRNA.org database source was used to predict the target genes of the identified differentially expressed miRNAs. We integrated the target genes and their interacted genes (predicted by STRING) into DAVID to perform the GO function and KEGG pathway analyses.Compared to the normal control, a total of 21, 47, and 107 differentially expressed miRNAs were screened in DCIS, invasive and metastatic breast cancer, respectively. Specific differentially expressed miRNAs of the three subtypes were identified, including hsa-miR-99a and hsa-miR-151-3p for DCIS breast cancer, hsa-miR-145 and hsa-miR-210 for invasive breast cancer, and has-miR-205 and has-miR-361-5p metastatic breast cancer. Furthermore, 220, 43, 446, 307, 587 and 328 interaction pairs of the specific miRNA targets were predicted. Multiple GO functions and KEGG pathways were enriched with the miRNA targets and their interacted genes.We screened the most representative miRNAs of the three different subtypes of breast cancer, which may act as the putative markers in the diagnosis of different subtypes of breast cancer.

Due to non-specific symptoms and imaging features, a timely and accurate diagnosis of pulmonary thromboembolism (PTE) is often difficult. This study aims to evaluate the frequency of, and risk factors for, autopsy-confirmed cases with fatal pulmonary thromboembolism (FPE) that were missed or misdiagnosed before death.Forensic autopsies that were performed at the Center of Forensic Medicine in West China were retrospectively reviewed, and demographic and clinical data of autopsy-confirmed cases with FPE were collected.There were 41 cases with pathologically confirmed FPE, which represents 7.3% (41/558) of autopsy cases that documented sudden death in hospital. Of those 41 cases, only 14.6% (6/41) were correctly diagnosed before death, and 85.4% (35/41) were missed or misdiagnosed. According to medical records, bowel movements and out-of-bed activity were the major triggers of FPE death, and 90% of cases had at least two of the known risk factors for PTE. Increasing age, orthopedic surgery, and multiple traumas were the most common risk factors. Additionally, of the 41 cases with FPE, 51.2% (21/41) died in the Orthopedic Department.FPE was common in older patients who had a recent history of surgery and multiple traumas. Increasing the early diagnosis of PTE in high-risk patients may be useful for reducing the incidence of FPE.

The MAPT gene has been shown to be associated with several neurodegenerative disorders, including forms of parkinsonism and Parkinson disease (PD), but the results reveal population differences. We investigated the association of 10 single-nucleotide polymorphisms (SNPs) in the region of MAPT on chromosome 17q21 with PD and age at onset, by using 443 discordant sib pairs in PD from a public dataset (Mayo-Perlegen LEAPS Collaboration). Association with PD was assessed by the FBAT using generalized estimating equations (FBAT-GEE), while the association with age at onset as a quantitative trait was evaluated using the FBAT-logrank statistic. Five SNPs were significantly associated with PD (Plt; 0.05) in an additive model, and 9 SNPs were associated with PD (Plt; 0.05) in dominant and recessive models. Interestingly, 8 PD-associated SNPs were also associated with age at onset of PD (Plt; 0.05) in dominant and recessive models. The SNP most significantly associated with PD and age at onset was rs17649641 (P = 0.015 and 0.021, respectively). Two-SNP haplotypes inferred from rs17563965 and rs17649641 also showed association with PD (P = 0.018) and age at onset (P = 0.026). These results provide further support for the role of MAPT in development of PD.

The aim of this study was to investigate the outcome in 556 patients with locally advanced nasopharyngeal carcinomas treated by radiation therapy alone. We observed 556 patients with stage T3-4 and N0-3 carcinoma who were treated by conventional radiotherapy alone between January and December 1999. The total dose delivered to the nasopharynx was 66-80 Gy over 6.5-8 weeks and to the neck lymph nodes 60-70 Gy over 6-7 weeks. The 5-year actuarial overall survival rate (OS) reached 66.41%. The OS was higher among stage T3 patients than among stage T4 patients (69.12% vs 58.96%, p = 0.0359). Among patients with stage N0, N1, N2 and N3 disease, the OS was 73.98%, 65.96%, 57.58% and 29.39%, respectively (p = 0.0009). Differences in disease-free survival, locoregional control rate and metastasis-free survival rate among each N stage were statistically significant, although this was not true of differences between stage T3 and T4 disease. Multivariate analysis showed that gender, age, T stage and N stage were significant prognostic factors for 5-year overall survival, disease-free survival, locoregional control and metastasis-free survival. We found that N stage is the dominant prognostic indicator for patients with locally advanced nasopharyngeal carcinoma receiving conventional radiation therapy alone, and that T stage was only a secondary correlative factor.

Much has been published on the natural history of intermittent claudication (IC), but little is known about the clinical features of stroke patients with IC. The purpose of this study was to examine clinical features and risk factors in stroke patients with or without IC, including heart disease and carotid artery disease. A hospital-based study was conducted of 3901 stroke patients, who were prospectively coded and entered into a computerized databank. Of these patients, 219 had symptoms of IC. Patients were subdivided by age into 10-year categories. There were at least 12 times more non-IC than IC patients in each category. An age-matched random sample was obtained containing 12 non-IC cases for each IC case, resulting in 219 cases of IC and 2628 non-IC cases. The prevalence of IC in the total stroke population was 5.6%. IC prevalence increased sharply with age until about 70 years. Cardiac ischaemia and internal carotid artery (ICA) disease were significantly more frequent in stroke with IC than without IC. IC patients also exhibited a higher prevalence of atherosclerotic disease as well as other risk factors such as smoking, hypercholesterolaemia, elevated haematocrit, and family history of stroke. Ischaemic heart disease and ICA disease are especially common in stroke with IC. IC, large artery disease and stroke share similar risk factors. IC symptoms in stroke patients may indicate extensive generalized atherosclerosis.

This study was conducted to determine whether the paranasal extension of a primary non-Hodgkin's lymphoma (NHL) of the nasal cavity has any deleterious effect on patient outcome.One hundred and seventy-five patients with previously untreated nasal NHL were reviewed. There were 2 with low grade, 107 with intermediate grade, 17 with high grade, and 49 with unclassifiable lymphomas. In 48 cases the immunophenotype was available and 46 were T-cell lymphoma. According to the Ann Arbor system, there were 133 patients with Stage IE, 28 with Stage IIE, 4 with Stage IIIE, and 10 with Stage IVE lymphomas. Stage IE was subdivided into limited Stage IE (i.e., confined to the nasal cavity [67 patients]) or extensive Stage IE (i.e., presenting with extension beyond the nasal cavity [66 patients]). For patients with limited Stage IE disease the treatment of choice was radiotherapy with or without chemotherapy. In patients with extensive Stage IE disease, treatment was comprised of a combination of chemotherapy and radiotherapy or radiotherapy alone. For patients with a more advanced stage of disease (IIE-IVE), chemotherapy was an integral part of the treatment and was completed by irradiation, especially for patients with Stage IIE disease.The actuarial overall survival (OS) and disease free survival (DFS) rates at 5 years for the whole group were 65% and 57%, respectively. The 5-year OS and DFS rates were influenced by stage, with a gradual decrease from 75% and 68% for Stage IE disease to 35% and 28% for Stage IIE disease, and 31% and 19% for Stage IIIE/IVE disease. Patients with limited Stage IE disease survived significantly longer (90% 5-year OS) compared with those with extensive Stage IE disease (57% 5-year OS; P0.001). For 67 patients with limited Stage IE disease, the 5-year OS was 89% with radiotherapy alone and 92% with radiotherapy and chemotherapy, whereas for 66 patients with extensive Stage IE disease, the 5-year OS was 54% with radiotherapy and 58% with combined modality therapy or chemotherapy (P0.05).The prognosis of patients with primary NHL of the nasal cavity is stage dependent. In this large cohort of Stage IE patients, it was demonstrated that the paranasal local extension was a significant prognostic factor associated with poorer treatment outcome. The authors believe that Ann Arbor Stage IE should be subclassified further into limited and extensive Stage IE. The addition of chemotherapy did not appear to modify significantly the survival of patients with either limited or extensive Stage IE disease. The extranodal progression observed in patients with extensive Stage IE and Stage IIE-IVE disease clearly illustrates the need for improvement of systemic treatment.

An immunohistochemical study was performed on trephine biopsy specimens of bone marrow in 10 patients with myelodysplastic syndromes (MDS). Monoclonal antibodies HIP7 and CDW41 were used against platelet glycoprotein IIb/IIIa (CD41) to determine dysmegakaryopoiesis including its size, proportion of micromegakaryocytes, location and staining characteristics. The results show that the dysmegakaryopoiesis of MDS includes the increased number and high proportion of micromegakaryocytes, the altered architectural distribution and the considerable variation in staining. These may be helpful in the diagnosis and differential diagnosis of MDS.

The authors compared bone marrow histological changes in 28 cases of myelodysplastic syndrome (MDS), 21 cases of aplastic anemia and 8 cases of hemolytic anemia. It is shown that abnormal localization of immature precursors (ALIP) is a characteristic change in MDS. The presence of erythroblastic islands and the variance of morphology of megakaryocytes are valuable for diagnosis. The histological method for the observation of lymphoid micromegakaryocytes is not so accurate as cytological method. "ALIP" can more or less help to evaluate the prognosis of MDS. According to the histological changes, it is easy to differentiate the three types of anemia we studied.

This paper reports 40 patients with primary gastric malignant lymphoma as proved by pathology and treated in our hospital from October 1958 to December 1984. There were 20 males and 20 females, including 3 Hodgkin's disease and 37 non-Hodgkin's lymphoma. The patients were treated by surgery, radiotherapy and chemotherapy separately or combined. In this series, the 5 and 10 year survival rates were 48.6% and 47.6%. The combination of surgery with postoperative radiotherapy and/or chemotherapy gave better results. In postoperative radiation to the whole abdomen, the tissue dose should not be less than 30-35 Gy. The incidence, diagnosis, clinical staging and the indication of primary gastric malignant lymphoma are discussed with a review of literature.