Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) has been linked to an elevated risk of cardiovascular diseases and mortality in adults. The impact of MASLD on pediatric cardiovascular development remains insufficiently characterized. Methods: This prospective pediatric cohort study enrolled 1,914 primary school children from Beijing, China, with a 4.5-year follow-up beginning in October 2018. Baseline MASLD was assessed via ultrasonic screening followed by anthropometric measurement and blood assays. Carotid intima-media thickness (cIMT) was measured by vascular ultrasonography, and left ventricular mass (LVM) and LVM index (LVMI) were determined by echocardiography at baseline and follow-up. We identified differences in cIMT, LVM and LVMI between adolescents with or without baseline MASLD. Results: Among 1,356 adolescents included in the analysis, we identified 94 with MASLD at baseline. Over a follow-up period of 4.5 years, adolescents with baseline MASLD (BW-MASLD) presented with significantly higher cardiometabolic indicators and alanine transaminase levels at both baseline and follow-up. At follow-up, the BW-MASLD group presented significantly greater cIMT, LVM, and LVMI (0.55 mm, 85.4 g, and 24.8 g/m2.7, respectively) relative to adolescents without baseline MASLD (0.51 mm, 66.4 g, and 21.6 g/m2.7, respectively; BN-MASLD). Consistent findings were observed in the stratified analysis by sex and overweight status. Conclusion: Adolescents with childhood MASLD show greater cardiovascular structure, with consistently elevated cardiometabolic disorders. This underscores the crucial importance of managing MASLD early on to mitigate the risks of cardiovascular structural remodeling.

BACKGROUND:Metabolic dysfunction-associated steatotic liver disease (MASLD) is prevalent in children. This study aimed to determine the sex-specific association between pubertal development and risk of MASLD in children. METHODS:This longitudinal study included 1544 children aged 10-13 years from two follow-ups of a Chinese pediatric cohort (the PROC study) in Beijing. Pubertal development was assessed using Tanner staging. We employed Bayesian logistic regression to examine the cross-sectional association between pubertal development and MASLD, and employed Bayesian mixed-effects models to verify its longitudinal association. External validation was performed using National Health and Nutrition Examination Survey (NHANES) data, where puberty was defined by total testosterone in boys and estradiol in girls. RESULTS:The overall prevalence of MASLD declined with advancing pubertal stages. In boys, compared with early puberty, mid-puberty (aOR = 0.34, 95% highest density interval (HDI): 0.11-0.68) and late puberty (aOR = 0.22, 95% HDI: 0.03-0.59) showed significantly lower MASLD risk. No significant association was observed among girls. NHANES validation confirmed this protective association in boys at late puberty (aOR = 0.25, 95% HDI: 0.01-0.95), but not in girls. CONCLUSIONS:Mid-to-late puberty may significantly decrease the risk of MASLD in boys, whereas no clear association was observed in girls. IMPACT:This study reveals a sex-specific protective effect of puberty on MASLD risk in children, with advancing puberty associated with significantly lower odds of MASLD in boys, but not in girls. It adds longitudinal evidence on the puberty-MASLD association by assessing puberty via Tanner staging and conducting sex-specific analyses. The impact is to support tailoring prevention resources and health messages for MASLD by sex during puberty.

Suboptimal hydration status has increasingly been recognized as a risk factor for the progression of chronic diseases. A nationwide survey conducted in China found that 82% of children aged 6 to 17 years failed to meet the recommended daily total water intake of 1600–2500 mL. On average, boys consumed 1603 ± 731 mL per day, while girls consumed 1487 ± 661 mL per day, placing them at a higher risk of dehydration. Worldwide studies have suggested associations between dehydration and chronic kidney disease, steatotic liver disease, and cardiovascular diseases in adults. However, there is a lack of evidence concerning hydration status and target organ damage in the pediatric population. Only a limited number of studies have suggested that suboptimal hydration status is associated with transient renal impairment, an increased risk of metabolic dysfunction-associated steatotic liver disease (MASLD), and decreased ventricular structure and function in children. This article reviews the association between hydration status and target organ damage in both adult and pediatric populations and summarizes tailored water intake recommendations for Chinese children. We aim to advance research on hydration status and kidney, liver, and cardiovascular health, especially in the pediatric population.

INTRODUCTION:We investigated the impact of metabolic dysfunction-associated steatotic liver disease (MASLD) on cardiovascular structure development in children. METHODS:We followed 1,356 children with the mean age of 6.6 years for 4.5 years in Beijing, China. We assessed the association of MASLD with cardiovascular structure (carotid intima-media thickness and left ventricular mass) outcomes at baseline and follow-up. RESULTS:Over follow-up, 59 children had persistent MASLD, 109 had incident MASLD (progression), and 35 had normalization of liver health. Children with MASLD normalization showed a significantly lower mean development in carotid intima-media thickness (0.161 vs 0.188 mm) and left ventricular mass (4.5 vs 12.4 g) than children with persistent MASLD. DISCUSSION:The control of MASLD was associated with improved cardiovascular structure development.

Background: While dehydration is associated with pediatric renal impairment, the regulation of hydration status can be affected by sleep. However, the interaction of hydration and sleep on kidney health remains unclear. Methods: We conducted a cohort study among 1914 healthy primary school children from October 2018 to November 2019 in Beijing, China. Four-wave urinary β2-microglobulin and microalbumin excretion were assayed to assess transient renal tubular and glomerular impairment, and specific gravity was measured to determine hydration status with contemporaneous assessment of sleep duration, other anthropometric, and lifestyle covariates. We used generalized linear mixed-effects models to assess longitudinal associations of sleep duration and hydration status with renal impairment. Results: We observed 1378 children with optimal sleep (9–<11 h/d, 72.0%), 472 with short sleep (<9 h/d), and 64 with long sleep (≥11 h/d, 3.3%). Over half (55.4%) of events determined across 6968 person-visits were transient dehydration, 19.4% were tubular, and 4.9% were glomerular impairment events. Taking optimal sleep + euhydration as the reference, the results of generalized linear mixed-effects models showed that children with long sleep + dehydration (odds ratio [OR]: 3.87 for tubular impairment [tubules] and 3.47 for glomerular impairment [glomerulus]), long sleep + euhydration (OR: 2.43 for tubules), optimal sleep + dehydration (OR: 2.35 for tubules and 3.00 for glomerulus), short sleep + dehydration (OR: 2.07 for tubules and 2.69 for glomerulus), or short sleep + euhydration (OR: 1.29 for tubules) were more likely to present transient renal impairment, adjusting for sex, age, body mass index z-score, systolic blood pressure z-score, screen time, physical activity, and Mediterranean diet adherence. Conclusions: Dehydration and suboptimal sleep aggravate transient renal impairment in children, suggesting its role in maintaining pediatric kidney health.

Few studies have examined the sex differences in left ventricle (LV) structure and physiology from early life stages. We aimed to assess the role of sex and overweight/obesity on left ventricular mass (LVM) and LV volume in Chinese children without preexisting cardiovascular risk factors. We selected 934 healthy children aged 6–8 years from an existing cohort in Beijing, China. Linear regression models were used to regress body mass index (BMI), fat mass, systolic blood pressure, diastolic blood pressure, waist circumference, and visceral fat area (VFA) with LVM, left ventricle end-diastolic volume (LVEDV) and end-systolic volume (LVESV). Higher BMI, fat mass, waist circumference, VFA, and stroke volume (SV) predicted higher LVM, LVEDV, and LVESV in both sexes. Multivariable analysis showed that boys with an elevated BMI had greater LV hypertrophy. LVEDV and LVESV were higher among boys than among girls and increased with higher BMI in both boys and girls. LVEDV and LVESV were associated with VFA in boys. We observed sex differences in LVM, LVESV, and LVEDV among prepubertal children, independent of obesity, with higher values observed in boys. Sex differences in cardiac structure in children may help explain the higher incidence of cardiovascular disease in male adults. Whether interventions to reduce childhood obesity can improve the trajectory of cardiac dynamics is worth investigating.

Dehydration is common in children for physiological and behavioral reasons. The objective of this study was to assess changes in hydration status and renal impairment across school weekdays. We conducted a longitudinal study of three repeated measures of urinalysis within one week in November 2019 in a child cohort in Beijing, China. We measured urine specific gravity (USG) to determine the dehydration status, and the concentration of β2-microglobulin (β2-MG) and microalbumin (MA) to assess renal function impairment among 1885 children with a mean age of 7.7 years old. The prevalence of dehydration was 61.9%, which was significantly higher in boys (64.3%). Using chi-square tests and linear mixed-effects regression models, we documented the trends of the renal indicators’ change over time among different hydration statuses. Compared to Mondays, there were apparent increases of β2-MG concentrations on Wednesdays (β = 0.029, p < 0.001) and Fridays (β = 0.035, p < 0.001) in the dehydrated group, but not in the euhydrated group. As for the MA concentrations, only the decrease on Fridays (β = −1.822, p = 0.01) was significant in the euhydrated group. An increased trend of elevated β2-MG concentration was shown in both the euhydrated group (Z = −3.33, p < 0.001) and the dehydrated group (Z = −8.82, p < 0.001). By contrast, there was a decreased trend of elevated MA concentrations in the euhydrated group (Z = 3.59, p < 0.001) but not in the dehydrated group. A new indicator ratio, β2-MG/MA, validated the consistent trends of renal function impairment in children with dehydration. Renal impairment trends worsened as a function of school days during the week and the dehydration status aggravated renal impairment during childhood across school weekdays, especially tubular abnormalities in children.

The impact of HIV infection on the natural history of COVID-19 is unknown, given the recency of the human spread of SARS-CoV-2 (CoV). We reviewed published case series/reports of CoV-HIV coinfections to clarify epidemiologic and clinical features in China, the first nation with pandemic experience. Assuming that HIV-infected persons were at average risk of CoV infection in Wuhan, we estimated HIV-CoV coinfected persons to number 412 (95%CI: 381-442); our review encompassed an estimated 16.7% (69/412) of Wuhan. Men (many of whom reported sex with other men) accounted for 71.1% (54/76) of the cases reported in China. The median age was 48.0 years old (range 24-77, interquartile:37-57). The median CD4+ cell count at the last clinical visit was 421 cells/μL; 83.0% had an undetectable viral load. Among 31 patients with clinical details reported, fatigue (41.9%), respiratory distress (41.9%), and gastrointestinal symptoms (26.7%) were most common. Among the 52 cases reporting COVID-19 clinical severity, 46.2% were severe, 44.2% mild, and 9.6% asymptomatic COVID-19. Late antiretroviral therapy (ART) was reported by 30.4% (7/23) among whom 57.1% (4/7) were confirmed as severe COVID-19. The case fatality rate was 9.1% (3/33). Severe disease and death were less common among persons who took ART prior to the COVID-19 diagnosis. Of 16 reported IL-6 results, 68.7% were within the normal range. Earlier use of ART was associated with a better COVID-19 prognosis with CoV-HIV co-infection reported from China through early 2021, but small sample sizes limit definitive conclusions.

Healthy diet patterns have a positive effect on chronic non-communicable diseases in the pediatric population, but the evidence is limited on the association between kidney impairment and adherence to a Mediterranean diet. We aim to determine the associations between Mediterranean diet adherence and longitudinal tubular and glomerular impairment in children. Based on four waves of urine assays conducted from October 2018 to November 2019, we assayed urinary β2-microglobulin (β2-MG) and microalbumin (MA) excretion to determine transient renal tubular and glomerular impairment during the follow-up of the child cohort (PROC) study in Beijing, China. We assessed Mediterranean diet adherence using the 16-item Mediterranean Diet Quality Index in children and adolescents (KIDMED) among 1914 primary school children. Poor, intermediate, and good adherence rates for the Mediterranean diet were 9.0% (KIDMED index 0–3), 54.4% (KIDMED index 4–7) and 36.5% (KIDMED index 8–12), respectively. A short sleep duration was more prevalent in children with lower Mediterranean diet adherence, with no significant differences presenting in the other demographic and lifestyle covariates. The results of linear mixed-effects models showed that a higher urinary MA excretion was inversely associated with a higher KIDMED score (β = −0.216, 95%CI: −0.358, −0.074, p = 0.003), after adjusting for sex, age, BMI z-score, SBP z-score, screen time, sleep duration and physical activity. Furthermore, in generalized linear mixed-effects models, consistent results found that transient renal glomerular impairment was less likely to develop in children with intermediate Mediterranean diet adherence (aOR = 0.68, 95%CI: 0.47, 0.99, p = 0.044) and in children with good Mediterranean diet adherence (aOR = 0.60, 95%CI: 0.40, 0.90, p = 0.014), taking poor Mediterranean diet adherence as a reference. We visualized the longitudinal associations between each item of the KIDMED test and kidney impairment via a forest plot and identified the main protective eating behaviors. Children who adhere well to the Mediterranean diet have a lower risk of transient glomerular impairment, underscoring the necessity of the early childhood development of healthy eating patterns to protect kidney health.

BackgroundOptimal water intake positively affects various aspects of human physiology, especially renal function. Physical activity (PA) may have an impact on hydration status and renal health, but the interaction of hydration status and PA level on renal function is not well-studied in children.MethodsWe conducted four waves of urine assays in our child cohort (PROC) study from October 2018 to November 2019 in Beijing, China. We measured urinary specific gravity, β2-microglobulin (β2-MG), and microalbumin (MA) excretion to assess hydration status and renal damage in the context of PA level and other covariates among 1,914 primary school children. We determined the associations of renal damage with the interaction of hydration status and PA level using generalized linear mixed-effects models.ResultsThe prevalence of dehydration was 35.0%, 62.1%, 63.9%, and 63.3%, and the prevalence of insufficient PA was 86.2%, 44.9%, 90.4%, and 90.2% from wave 1 to wave 4 among 1,914 primary school children. From wave 1 to wave 4, the prevalence of renal tubular damage had a significant increasing trend of 8.8%, 15.9%, 25.7%, and 29.0% (Z = 16.9, P < 0.001), while the prevalence of glomerular damage revealed a declining trend of 5.6%, 5.5%, 4.4%, and 4.1% (Z = −2.4, P = 0.016). There were stable longitudinal associations of renal tubular and glomerular damage with hydration status (euhydration: OR = 0.50 and 0.33, respectively) but not with PA level. In multivariate analysis, significant interactions of hydration status and PA level were noted with renal tubular damage (β = 0.43, P = 0.014) and glomerular damage (β = 0.60, P = 0.047). Children with euhydration and insufficient PA were less likely to have renal tubular damage (OR = 0.46, 95% CI: 0.39, 0.53) or glomerular damage (OR = 0.28, 95% CI: 0.20, 0.39); children with euhydration and sufficient PA were also less likely to have renal tubular damage (OR = 0.57, 95% CI: 0.44, 0.75) or glomerular damage (OR = 0.47, 95% CI: 0.30, 0.74), adjusting for age, sex, BMI z-score, standardized SBP, sleep duration, computer/cell phone screen time, and fruit and vegetable intake.ConclusionChildren with euhydration and either sufficient or insufficient PA were less likely to have early renal damage. Adequate daily water intake for children is important, especially after PA.

Since its first appearance in Wuhan, China, severe acute respiratory syndrome coronavirus 2 has rapidly spread throughout the world and has become a global pandemic. It remains unclear whether people living with human immunodeficiency virus are at an increased risk of coronavirus disease 2019 and severe disease manifestation; until now, the evidence regarding the outcomes from severe acute respiratory syndrome coronavirus 2 infection in people living with human immunodeficiency virus is still limited and conflicting. The clinical characteristics of seven patients of family cluster-onset coronavirus disease 2019 were reported, including the immune characteristics of one patient of human immunodeficiency virus/severe acute respiratory syndrome coronavirus 2 coinfection. In the patients of human immunodeficiency virus/severe acute respiratory syndrome coronavirus 2 coinfection, about 2 weeks after infection, it was observed that CD4 and CD8 count showed a downward trend and that of CD8 is more obvious; at the same time, lymphocytes showed a slight increase. CD4, CD8, and lymphocytes are in the plateau period from the second week to the fourth week. About 4 weeks after infection, all showed an increase, in which anti-coronavirus combined with antiviral therapy were given. The time for Nucleic Acid Testing to present as negative was 51 days. The other six patients in the family were non–human immunodeficiency virus infected, the familial cluster received parallel treatment, and the median time for the Nucleic Acid Testing to present as negative was 29 days. The patient of human immunodeficiency virus/severe acute respiratory syndrome coronavirus 2 coinfection presents an immune state of CD4’s and CD8’s dual lymphatic depletion. Human immunodeficiency virus should still be regarded as an important factor in future risk stratification models for coronavirus disease 2019.

Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by a novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) infection, and its spread speed Fast, the crowd is generally susceptible [1] AIDS (acquired immune deficiency syndrome, AIDS) is caused by human immunodeficiency virus (human immunodeficiency virus)

We present a case of multiple myeloma with primary systemic amyloidosis presenting with digestive symptoms in a 32-year-old male. Initial symptoms included upper abdominal discomfort for 4 months, and stool with mucous and blood for 1 month. Erosive gastritis, Helicobacter pylori infection, haematochezia, and weight loss were noted, but without bone pain, anaemia, or hypercalcaemia. Bone marrow examination showed 18.5% mature monoclonal plasma cells that were lambda light chain protein and CD38 positive. Three courses of 28-day PTD therapy (i.e., bortezomib, dexamethasone, and thalidomide) were administered. Gastrointestinal symptoms and laboratory parameters improved. Post-treatment follow-up showed 0.5% plasma cells with normal morphology in bone marrow, urine lambda light chain 10.1 mg/L, and negative M protein. Nevertheless, the patient died of multiple organ system failure 8 months after treatment. Conclusions: Amyloidosis is an uncommon finding in patients with multiple myeloma, especially in younger individuals. (C) 2020 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

目的 探讨含利妥昔单抗方案治疗B细胞非霍奇金淋巴瘤引起的间质性肺炎(IP)的临床特征.方法 2018年11月至2019年12月首都医科大学附属北京友谊医院收治含利妥昔单抗方案治疗的CD20阳性B细胞非霍奇金淋巴瘤患者114例,其中有症状的IP患者5例,回顾性分析5例IP患者的临床资料.结果 5例含利妥昔单抗方案治疗后的IP患者最常见的症状是干咳、劳累性呼吸困难和发热,其他不常见和非特异性的症状包括疲劳、气喘、咯血、皮疹和胸痛.部分患者在诊断时是无症状的,通过CT或正电子发射计算机断层显像-CT检测到间质性肺病,肺功能提示中重度弥散功能降低,血气分析提示低氧血症,严重者可表现为Ⅰ型呼吸衰竭.影像学典型表现为局限或双肺的磨玻璃影,少数也表现为斑片状实变影、结节影.经酌情停用利妥昔单抗并给予糖皮质激素治疗好转.结论 含利妥昔单抗治疗方案可导致IP的发生,可能与细胞因子释放、免疫力降低及真菌或卡氏肺孢子虫感染相关,治疗上根据临床指标和影像学资料经验性应用糖皮质激素和抗卡氏肺孢子虫或抗真菌治疗,效果显著.

We present a case of multiple myeloma with primary systemic amyloidosis presenting with digestive symptoms in a 32-year-old male. Initial symptoms included upper abdominal discomfort for 4 months, and stool with mucous and blood for 1 month. Erosive gastritis, Helicobacter pylori infection, haematochezia, and weight loss were noted, but without bone pain, anaemia, or hypercalcaemia. Bone marrow examination showed 18.5% mature monoclonal plasma cells that were lambda light chain protein and CD38 positive. Three courses of 28-day PTD therapy (i.e., bortezomib, dexamethasone, and thalidomide) were administered. Gastrointestinal symptoms and laboratory parameters improved. Post-treatment follow-up showed 0.5% plasma cells with normal morphology in bone marrow, urine lambda light chain 10.1 mg/L, and negative M protein. Nevertheless, the patient died of multiple organ system failure 8 months after treatment. Conclusions: Amyloidosis is an uncommon finding in patients with multiple myeloma, especially in younger individuals. (C) 2020 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

Background. Understanding health worker awareness, attitudes, and self-confidence in the workplace can inform local and global responses toward emerging infectious threats, like the coronavirus disease 2019 (COVID-19) pandemic. Availability of accessible personal protective equipment (PPE) is vital to effective care and prevention. Methods. We conducted a cross-sectional survey from February 24 to 28, 2020, to assess COVID-19 preparedness among health workers. In addition, we assessed trends from search engine web crawling and text-mining data trending over the Sina Weibo platform from January 1 to March 3, 2020. Data were abstracted on Chinese outbreak preparedness. Results. In the survey, we engaged 6350 persons, of whom 1065 agreed to participate, and after an eligibility logic check, 1052 participated (16.6%). We accessed 412 internet posts as to PPE availability. Health workers who were satisfied with current preparedness to address COVID- 19 were more likely to be female, to obtain knowledge about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak from government organizations, and to consider their hospital prepared for outbreak management. Health workers with more confidence in their abilities to respond were those with more faith in their institution's response capacities. Elements of readiness included having airborne infection isolation rooms, visitor control procedures, and training in precautions and PPE use. Both survey and web post assessments suggested that health workers in need were unable to reliably obtain PPE. Conclusions. Health workers' self-confidence depends on perceived institutional readiness. Failure to maintain available PPE inventory for emerging infectious diseases preparedness suggests a failure to learn key lessons from the 2003-2004 SARS outbreak in China.

Background: Confirmed as a familial clustered case, a COVID-19 patient displaying established symptoms was simultaneously diagnosed with an HIV infection, and treated with several antiviral and compassionate drugs. Case presentation: The upper respiratory tract Nucleic Acid Testing (NAT) for the novel coronavirus continued to be positive for consecutive 49 days. During the course of treatment, it was observed that the other six cases in the family were non-HIV infected and displaying common Covid-19 symptoms, the familial cluster received parallel treatment along with the aforementioned patient, and the median time for the NAT to present as negative was 29 days. Conclusions: The results of this research indicate that the novel coronavirus attacks T lymphocyte subsets, andfurther studies with larger sample sizes are required to verify how the immune escape mechanism of the new coronavirus interacts with HIV infection.

Objective: To investigate the clinical effect of thoracoscopic radical resection of lung cancer in the treatment of early non-small cell lung cancer. Methods: Data were collected from 97 patients with early non-small cell lung cancer admitted to our hospital between March 2018 and March 2019. The patients were divided into control group (n=48) and research group (n=49) according to the digital random method. Routine thoracotomy and thoracoscopic radical resection of lung cancer were used respectively. The clinical therapeutic effects of the two groups were compared. Fruit. Results: The operation time of the study group was longer than that of the control group. The intraoperative bleeding volume, thoracic drainage volume, hospitalization time and dosage of analgesics after operation were all less than those of the control group (p < 0.05); the levels of inflammatory factors in the study group were significantly lower than those of the control group (p < 0.05). The incidence of complications was 6.12% (3/49) in the study group and 20.83% (10/48) in the control group. There was significant difference between the two groups (p < 0.05). CONCLUSION: Thoracoscopic radical resection of lung cancer for early non-small cell lung cancer is effective, the recovery of patients is faster, the incidence of complications is reduced, and the biochemical indicators are significantly decreased after operation, which is worthy of clinical promotion.

Background: Non-Hodgkin T/NK cell lymphoma is a rare and widely variable type of lymphoma with the most dismal prognosis. This study aimed to investigate varied impact of the clinical indicators to the overall survival (OS). Methods: We conducted a retrospective study to identify the non-invasive clinical features of T cell lymphoma that can predict prognosis with an innovative analysis method using quantile regression. A total of 183 patients who visited a top-tier hospital in Beijing, China, were enrolled from January 2006 to December 2015. Demographic information and main clinical indicators were collected including age, erythrocyte sedimentation rate (ESR), survival status, and international prognostic index (IPI) score. Results: The median age of the patients at diagnosis was 45 years. Approximately 80% of patients were at an advanced stage, and the median survival time after diagnosis was 5.1 months. Multivariable analysis of the prognostic factors for inferior OS associated with advanced clinical staging [HR=3.16, 95%C1 (1.39-7.2)], lower platelet count [HR =2.57, 95%CI (1.57-4.19), P < 0.001] and higher IPI score [HR =1.29, 95%CI (1.01-1.66), P=0.043]. Meanwhile, T cell lymphoblastic lymphoma [HR =0.40, 95%Cl (0.20-0.80), P=0.010], higher white blood cell counts [HR =0.57, 95%CI (0.34-0.96), P=0.033], higher serum albumin level [I IR =0.6, 95%Cl (0.37-0.97), P=0.039], and higher ESR [I IR =0.53, 95%C[ (0.33-0.87), P=0.0111 were protective factors for OS when stratified by hemophagocytic lymphohistiocytosis (HLH). Multivariable quantile regression between the OS rate and each predictor at quartiles 0.25, 0.5, 0,75, and 0.95 showed that the coefficients of serum beta 2-microglobulin level and serum ESR were statistically significant in the middle of the coefficient curve (quartile 0.25-0.75). The coefficient of 111 was negatively associated with OS. The coefficients of hematopoietic stem cell transplantation (HSCT) and no clinical symptoms were higher at the middle of the quartile level curve but were not statistically significant. Conclusions: The IPI score is a comparatively robust indicator of prognosis at 3 quartiles, and serum ESR is stable at the middle 2 quartiles section when adjusted for I 1111. Quantile regression can be used to observe detailed impacts of the predictors on OS.

Objective To analyze the clinical characteristics, pathological types, treatment modalities of lymphoma patients with mediastinal bulky masses. Methods The clinical data of 17 lymphoma patients with mediastinal bulky masses from January 2010 to January 2017 in Beijing Friendship Hospital were analyzed retrospectively. Results All the patients were pathologically diagnosed, including 6 cases of primary mediastinal large B-cell lymphoma , 5 cases of lymphoblastic lymphoma , 3 cases of Hodgkin lymphoma and 3 cases of other non-Hodgkin lymphoma. Four cases with bulky disease were treated with combined chemoradiotherapy regimen, 7 cases were treated with combined chemotherapy, 5 cases were treated with combined chemotherapy regimens followed by autologous bone marrow transplantation and 1 case was treated with high dose chemotherapy followed by allogeneic stem cell transplantation. The effects were evaluated after the final treatments. Twelve patients achieved complete remission, 1 case achieved partial remission, 1 case achieved stable disease, 1 case achieved progressive disease and 3 cases died. Conclusions The prognosis of lymphoma patients with mediastinal bulky masses is related with histopathology and treatment response. Combined treatment modalities including chemoradiotherapy regimen and chemotherapy regimen followed by autologous or allogeneic stem cell transplantation are helpful to improve treatment effects.