Search

Objective·To analyze the clinicopathologic characteristics of patients with kidney-involved diffuse large B-cell lymphoma (DLBCL), including clinical characteristics, pathological characteristics, gene mutation profiles, and prognostic factors.Methods·One hundred and forty-nine patients with kidney-involved DLBCL, admitted to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from July 2005 to November 2021, were retrospectively analyzed for their clinicopathological data, survival and prognostic factors, which included therapeutic methods, clinical outcomes, staging, etc. Gene mutation profiles were evaluated by targeted sequencing of 54 lymphoma-related genes. Prognostic factors were also analyzed based on the information mentioned above.Results·A total of 149 kidney-involved DLBCL cases were included, of which 89 patients (58.4%) were aged over sixty, 121 patients (81.2%) were staged Ann Arbor Ⅲ‒Ⅳ, 27 patients (18.1%) had an Eastern Cooperative Oncology Group (ECOG) performance status of two or more, 121 patients (81.2%) had elevated serum lactate dehydrogenase (LDH) level, 111 patients (74.5%) had extranodal invasion in at least two organs and 131 patients (87.9%) scored over 2 points on the international prognosis index (IPI). The estimated 5-year overall survival (OS) rate and progression-free survival (PFS) rate of kidney-involved DLBCL patients were 52.2% and 50.4% respectively. Univariate analysis revealed that elevated serum LDH levels were an adverse prognostic factor for both OS (P=0.048) and PFS (P=0.033). In pathological characteristics, 145 patients (97.3%) belonged to DLBCL, not otherwise specified (NOS) and 39 patients (26.3%) belonged to germinal center B-cell (GCB) according to Hans classification. Among 144 patients who could be evaluated for clinical outcomes, 87 patients (60.4%) got complete response (CR). Targeted sequencing data from 75 kidney-involved DLBCL patients showed high mutation frequency in PIM1 (n=23, 31%), MYD88 (n=22, 29%), CD79B (n=21, 28%) and KMT2D (n=18, 24%), with CD79B mutation indentified as an adverse prognostic factor for OS in patients with kidney-involved DLBCL (P=0.034).Conclusion·Elevated serum LDH level is an adverse prognostic factor in patients with kidney-involved DLBCL. The prognosis of patients with CD79B mutations is poor.

Objective·To analyze the clinicopathologic characteristics, gene mutation profile, and prognostic factors of thyroid diffuse large B-cell lymphoma (DLBCL).Methods·From November 2003 to December 2021, a total of 66 patients with thyroid DLBCL [23 cases (34.8%) with primary thyroid DLBCL, and 43 cases (65.2%) with secondary thyroid DLBCL] admitted to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed for their clinicopathological data, survival and prognostic factors. Gene mutation profiles were evaluated by targeted sequencing (55 lymphoma-related genes) in 40 patients.Results·Compared to primary thyroid DLBCL, secondary thyroid DLBCL had advanced ratio of Ann Arbor stage Ⅲ‒Ⅳ (P=0.000), elevated serum lactate dehydrogenase (LDH) (P=0.043), number of affected extranodal involvement ≥2 (P=0.000), non-germinal center B cell (non-GCB) (P=0.030), BCL-2/MYC double expression (DE) (P=0.026), and international prognostic index (IPI) 3‒5 -scores (P=0.000). The proportion of patients who underwent thyroid surgery (P=0.012) was lower than that of patients with primary thyroid DLBCL. The complete remission (CR) rate in primary thyroid DLBCL patients was higher than that in secondary thyroid DLBCL patients (P=0.039). Fifty-five patients (83%) received rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)-based first-line regimen. The estimated 5-year progression free survival (PFS) rate of primary thyroid DLBCL patients was 95.0%, higher than the 49.7% of the secondary patients (P=0.010). Univariate analysis showed that Ann Arbor Ⅲ‒Ⅳ (HR=4.411, 95%CI 1.373‒14.170), elevated LDH (HR=5.500, 95%CI 1.519‒19.911), non-GCB (HR=5.291, 95%CI 1.667‒16.788), and DE (HR=6.178, 95%CI 1.813‒21.058) were adverse prognostic factors of PFS in patients with thyroid DLBCL. Ann Arbor Ⅲ‒Ⅳ (HR=7.088, 95%CI 0.827‒60.717), elevated LDH (HR=6.982, 95%CI 0.809‒60.266), and DE (HR=18.079, 95%CI 1.837‒177.923) were adverse prognostic factors of overall survival (OS). Multivariate analysis showed that Ann Arbor Ⅲ‒Ⅳ (HR=4.693, 95%CI 1.218‒18.081) and elevated LDH (HR=5.058, 95%CI 1.166‒21.941) were independent adverse prognostic factors of PFS in patients with thyroid DLBCL. Targeted sequencing data showed mutation frequency >20% in TET2 (n=14, 35%), KMT2D (n=13, 32%), TP53 (n=11, 28%), GNA13 (n=10, 25%), KMT2C (n=9, 22%), and TP53 were adverse prognostic factors of PFS in patients with thyroid DLBCL (P=0.000).Conclusion·Patients with primary thyroid DLBCL have better PFS and OS than those with secondary thyroid DLBCL. Ann Arbor Ⅲ‒Ⅳ, elevated LDH, non-GCB, and DE (MYC and BCL2) are adverse prognostic factors in thyroid DLBCL. TET2, KMT2D, TP53, GNA13, and KMT2C are commonly highly mutated genes in thyroid DLBCL, and the prognosis of patients with TP53 mutations is poor.

Objective: To investigate the clinicopathological features and prognosis of duodenal-type follicular lymphoma (DFL). Methods: The clinical features, endoscopic appearances, pathological features, and treatments of 17 patients with DFL were retrospectively analyzed and followed up. Results: Among the 17 cases of DFL, there were 8 males and 9 females, with a male-to-female ratio of 1∶1.125. The median age was 58 years (33-67 years). Among them, 13 patients with DFL were found in routine physical examination, and most of them showed granular hyperplasia under endoscopy. Among the cases, 15 (88.2%) occurred in the duodenum, and all were located in the descending part of the duodenum. There were 15 cases of single lesions and 2 cases of multiple lesions. Under the microscope, the lesions were located in the mucosal layer or submucosal layer, with a clear or vague “expansive” growth pattern and visible follicular nodules. The nodules were composed of centrocyte-like cells and scattered centroblast-like cells, equivalent to grade 1 or 2 of classical follicular lymphoma. The tumor cells expressed CD20, CD79a, CD10, BCL6, and BCL2. CD21 staining of 9 cases showed that the follicular dendrite network was densely stained around the neoplastic follicles, but lightly stained and sparse in the center. Ki-67 expression was low. Four cases underwent second-generation gene sequencing, among which three cases had detected CREBBP gene mutations. Fourteen cases did not receive any treatment, and disease did not progress. One case underwent local intestinal segment resection without postoperative chemotherapy or radiotherapy and did not relapse. One case received chemotherapy and rituximab treatment, and the lesion completely disappeared. Conclusions: Most of DFL lesions are single lesions with microscopic manifestations similar to those of typical follicular lymphoma grade 1 or grade 2. The special immunophenotype is CD21, which is often more dense and deeply stained around the neoplastic follicles, and has inert biological behavior.

This article reports on research conducted to investigate student confidence in reading by collecting data from 135 primary schools in rural China. In the survey, we adopted the PIRLS scales of confidence in reading and reading skills test items. Our analysis shows that compared to the other countries and regions, rural China ranks last with regard to student confidence in reading and reading achievement. The correlation analysis reveals that in rural China there is a strong correlation between student confidence in reading and reading achievement. Additionally, school and teacher factors are associated with student confidence in reading. Specifically, having an accessible classroom library is associated with higher reading confidence, especially among the poor readers. Teacher instruction in reading correlates with higher confidence in readers for high achievers. Our findings indicate that the government should develop effective policies to improve student confidence in reading and reading skills in rural China.

To achieve common prosperity, we need to equalize the labor productivity in agriculture with that in other non-agricultural sectors. China’s agricultural labor productivity is less than 1/3 of that in the manufacturing and service industries. Our analysis on the trend of agricultural development suggests that it is essential to raise the agricultural labor productivity through internal labor division to ensure national food security. The breeding industry needs to transform toward scaled and modernized development and the planting industry needs to change to a new pattern—20% of large-scale farmers produce 80% of agricultural products or contribute 20% of added value while 80% of small-scale farmers produce 20% of agricultural products or contribute 80% of added value. Large-scale farmers mainly produce bulk agricultural products including grain to ensure food security while small-scale farmers develop highvalue agriculture to ensure income growth. Eventually, the labor productivity of large- and small-scale farmers will converge to achieve common prosperity, which is inevitable for China’s agricultural development and is an ideal vision in line with national realities. However, the task of transforming to the new pattern is arduous, and the government needs to make major strategic deployments and introduce corresponding safeguards and incentive measures. Particularly, it is necessary to establish a policy support system for large- and small-scale farmers, accelerate the progress of urban-rural integrated development, improve the land transfer markets, optimize the innovative system of agricultural science and technology as well as the human capacity building system, and establish an organizational guarantee system to realize agricultural modernization.

Objective To investigate the current status of supportive care needs in patients after total cystectomy and analyze its influencing factors. Methods A total of 631 patients undergoing total cystectomy in 5 tertiary Class-A hospitals in Chongqing from January 2020 to September 2021 were enrolled in this study. In 1 month after surgery, the patients were investigated by general data questionnaire and supportive care needs survey. Multiple linear regression analysis was used to analyze the influencing factors. Results The total score of supportive care needs for post-cystectomy patients was 107.71±7.77 and the mean score of the items was 4.14±0.30. Multiple linear regression analysis showed the post-cystectomy patients with higher monthly household income per capita (≥1 000 Yuan), spouse/children as primary caregivers, receiving bladder-sparing triple therapy (trimodal therapy, TMT), occupation as farmers, married/cohabitation, having rural cooperative medical insurance and undergoing surgical method with in situ neobladder had lower supportive care needs (P < 0.05). Conclusion The demand for specific supportive care of post-cystectomy patients is quite high. Monthly household income per capita, primary caregivers, receiving TMT or not, and surgical method with in situ neobladder are main factors influencing the demand for supportive care need in post-cystectomy patients.

This paper aims to explore and quantify the reading achievement of primary school students from three different regions in rural China. Using survey data on 23,143 students from Shaanxi, Guizhou, and Jiangxi provinces, we find although gaps in student reading achievement exist among the three sample provinces, all sample students exhibit low levels of reading achievement. Compared to students from other countries that participated in the Progress in International Reading Literacy Study reading tests, our sample students from rural China ranked last. Our regression analysis documented strong correlations between reading achievement and maths performance exist among the sample students in rural China. Additionally, we find male students, students with rural household registration, boarding students, and students from relatively poor families are more susceptible to having worse reading outcomes. Overall, our findings indicate the government should develop more effective policies to support reading skill development in China, especially in rural areas.

Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is rare in adults. The presence of intratumoral T lymphocytes and primitive rounded cells characterized this neoplasm. We report a 24-year-old Chinese man who developed EBV-SMT in the right adrenal gland with hepatitis B infection and autoimmune hemolytic anemia without a history of HIV infection, primary immune deficiency, organ transplantation, or malignant tumor. This patient had an unknown immunodeficient state. EBV-SMTs are commonly located in the liver, lung, and gastrointestinal tract but rarely in the adrenal gland. We reviewed 10 reported literature on EBV-SMT in the adrenal gland. It is imperative to distinguish EBV-SMT from conventional somatic smooth muscle tumors. The discovery of EBV-SMT forces the clinician to conduct a thorough evaluation of immune function and immune status surveillance, and these patients are vulnerable to subsequent malignant tumors. [ABSTRACT FROM AUTHOR]

It is commonly believed that reading challenges should be addressed early to reduce the likelihood that developmental delays will impact students over the long term. However, students in developing countries often have limited access to reading resources. In this study, the authors used a randomized controlled trial of 11,083 fourth- and fifth-grade students in 120 primary schools in rural China to examine the causal effect of an in-class library program on student reading outcomes and academic achievement in schools with poor reading resources over an eight-month period. An in-class library was installed in each of the selected classes in the 40 treatment schools. The authors found that the program significantly improved student affinity toward reading and student reading habits, and in these regards, it narrowed the gap between male and female students, between low- and high-performing students, and between left-behind children and children living with parents. However, the authors found no overall effect of the program on reading and academic achievement and a negative effect on student confidence in reading. There was also no effect on student, teacher, and primary caregiver perceptions toward the effect of independent reading on academic achievement, nor any effect on whether teachers and primary caregivers provided reading instructions to students. The authors propose three possible explanations for these findings: a lack of reading instruction from teachers and caregivers, a lack of reading materials specifically tailored to local needs and interests, and the relatively short duration of the intervention.

An increasing number of policy makers in developing countries have made the mass expansion of upper-secondary vocational education and training (VET) a top priority. The goal of this study is to examine whether VET fulfills these objectives of building skills and abilities along multiple dimensions and further identify which school-level factors help vocational students build these skills and abilities. To fulfill this goal, we analyzed representative, longitudinal data that we collected on more than 12,000 students from 118 schools in one province of central China. First, descriptive analysis shows that approximately 90 percent of VET students do not make any gains in vocational or general skills. In addition, negative behaviors (misbehavior in the classroom, antisocial behavior, and other risky behaviors) are highly prevalent among VET students. A nontrivial proportion of student internships also fail to meet minimum government requirements for student safety and well-being. Perhaps as a result of these outcomes, more than 60 percent of students express dissatisfaction with their VET programs, as evidenced by either self-reports or dropping out. Finally, using a multilevel model, we find that school inputs (such as school size, teacher qualifications, and per pupil expenditures) are not correlated with vocational and general skill at the end of the school year, or student dropout in the academic year.

The goal of this paper is to describe and analyze the relationship between ability tracking and student social trust, in the context of low-income students in developing countries. Drawing on the results from a longitudinal study among 1,436 low-income students across 132 schools in rural China, we found a significant lack of interpersonal trust and confidence in public institutions among poor rural young adults. We also found that slow-tracked students have a significantly lower level of social trust, comprised of interpersonal trust and confidence in public institutions, relative to their fast-tracked peers. This disparity might further widen the gap between relatively privileged students who stay in school and less privileged students who drop out of school. These results suggest that making high school accessible to more students may improve social trust among rural low-income young adults.

Background: Marginal zone lymphomas (MZLs) comprise a diverse group of indolent lymphoproliferative disorders; however, some patients develop histologic transformation (HT) with rapid progression to aggressive lymphoma. Methods: Forty‐three MZLs with HT (HT‐MZLs), 535 MZLs, and 174 de novo diffuse large B‐cell lymphomas (DLBCLs) without rearrangements of MYC, BCL2, and BCL6 were collected. Among these, 22 HT‐MZLs, 39 MZLs, and 174 DLBCLs were subjected to 148‐gene targeted exome sequencing. The clinicopathologic features of patients who had HT‐MZL and their genetic alterations were compared with those of patients who had MZLs and DLBCLs. Results: All 43 HT‐MZLs corresponded to DLBCLs. No HT‐MZLs harbored BCL2 and MYC and/or BCL6 rearrangements. Bone marrow involvement and higher levels of lactate dehydrogenase were significantly more common in HT‐MZLs than in MZLs. Furthermore, upregulated BCL6, MUM1, C‐MYC, and Ki‐67 expression was observed more frequently in HT‐MZLs than in MZLs. TBL1XR1 was the most frequently altered gene (63.6%) in HT‐MZLs, followed by CCND3 (31.8%), CARD11, ID3, and TP53 (22.7%). A trend toward worse progression‐free survival in patients with TBL1XR1 mutations was observed. Compared with MZLs and non–germinal center B‐cell (GCB) type DLBCLs, significantly higher frequencies of TBL1XR1 and ID3 mutations were identified in HT‐MZLs. PIM1 mutations frequently occurred in DLBCLs and were significantly associated with TBL1XR1 mutations but were mutated less in HT‐MZLs that had TBL1XR1 mutations. Conclusions: The current findings reveal the clinicopathologic and genetic features of HT‐MZLs, suggesting that these tumors might constitute a group distinct from MZL and de novo non–GCB type DLBCL. TBL1XR1 mutations may be considered a predictor of HT in MZL. A majority of marginal zone lymphomas with histologic transformation harbor TBL1XR1 mutations. Marginal zone lymphomas with histologic transformation exhibit immunophenotypic and genetic features that differ from those of marginal zone lymphomas and de novo diffuse large B‐cell lymphomas. [ABSTRACT FROM AUTHOR]

Maize(Zea mays. L) is a globally important crop, and understanding its genetic diversity is crucial for plant breeding phylogenetic analyses and comparative genetics. While nuclear markers have been extensively used for mapping agriculturally important genes, they are limited in recognizing characteristics, such as cytoplasmic male sterility and reciprocal cross hybrids. In this study, we performed next-generation sequencing of 176samples, and the maize cultivars represented five distinct groups. A total of 89 single nucleotide polymorphisms (SNPs) and 11 insertion/deletion polymorphisms (InDels) were identified. To enable high-throughput detection, we successfully amplified and confirmed 49 SNP and InDel markers, which were defined as a Varietal Chloroplast Panel (VCP) using the Kompetitive Allele Specific PCR (KASP). The specific markers provided a valuable tool for identifying chloroplast groups. The verification experiment, focusing on the identification of reciprocal cross hybrids and cytoplasmic male sterility hybrids, demonstrated the significant advantages of VCP markers in maternal inheritance characterization. Furthermore, only a small subset of these markers is needed to provide useful information, showcasing the effectiveness of these markers in elucidating the artificial selection process of elite maize lines. [ABSTRACT FROM AUTHOR]

Although a large number of students around the world attend vocational schools, there is little evidence about what factors matter for learning in these schools. Using data on approximately 1,400 vocational students in one eastern province in China, we employ a student fixed-effects model to identify whether teacher enterprise experience, direct occupational experience, and not just program training increases students' technical skills. We find this to be the case, especially for students who began the program as high performers. In contrast, "professional certification" that is given to teachers who participate in short-term training programs has no positive impact.