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摘要： Purpose: The survival benefit of postoperative adjuvant treatment (POAT) for stage II oral tongue squamous cell carcinoma (OTSCC) remains controversial. This large SEER-based study aims to establish a prognostic nomogram to visualize the overall survival of these patients and to aid in POAT decision making. Patients and Methods: The cut-off points of age at diagnosis and examined lymph node number (ELN) were determined using the population-based data from the SEER database. Univariate and multivariate Cox hazards regression models were utilized to identify prognostic factors that were integrated into the establishment of the prognostic nomogram. Patients with stage II OTSCC were then stratified into 3 cohorts based on this nomogram. The survival benefit of POAT was evaluated in these cohorts. Results: Age at diagnosis (with cutoff points of 50 and 75 years) and ELN (with cutoff points of 0 and 22) was significantly associated with the survival outcomes in patients with stage II OTSCC. After the multivariate analysis, 4 factors, including age at diagnosis, sex, ELN, and differentiation grade, were identified as independent prognostic factors. Additionally, a prognostic nomogram with these factors was constructed to predict overall survival and to stratify these patients. Only patients in the high-risk cohort could significantly benefit from postoperative adjuvant treatment. Conclusions: This prognostic nomogram could accurately predict the overall survival of stage II OTSCC patients after curative surgery. Notably, this model could also assist the decision-making of postoperative adjuvant treatment for patients with stage II OTSCC. (C) 2021 The American Association of Oral and Maxillofacial Surgeons.

关键词： Immune cell isolation   Mucosa   Fibrosis  

摘要： Understanding the interplay between immune and structural cells is important for studying fibrosis and inflammation;however, primary immune cell isolation from organs that are typically enriched in stromal cells, like the lung, esophagus, or gut, proves to be an ongoing challenge. In fibrotic conditions, this challenge becomes even greater as infiltrating cells become trapped in the robust extracellular matrix (ECM). This protocol details a method to isolate cells at high yield from stroma-rich organs that can be used for further analyses via flow cytometry, stimulation, or culturing. Validation of this method is confirmed by flow cytometry data assessing immune cell populations of interest. This protocol can be completed in approximately 5-6 h.

关键词： macule   patch   primary cutaneous B-cell lymphoma   follicle center-cell lymphoma   marginal-zone lymphoma  

摘要： Importance: Primary cutaneous B-cell lymphoma (PCBCL) classically presents with papules, plaques, nodules/ tumors. Previous reports of PCBCL manifesting with macular lesions are scarce, and focused on primary cutaneous follicle-center cell lymphoma (PCFCL), with limited data on its clinicopathological correlation. Objective: To report our experience with PCBCL presenting with erythematous macules. Design: Retrospective cohort. Setting: Two tertiary cutaneous-lymphoma outpatient clinics. Participants: Fourteen patients with low-grade PCBCL manifesting with erythematous patches, diagnosed and managed between January 2000 and December 2019. Intervention: Clinical data were collected from the medical files. Biopsy specimens of the macules, and if present of the typical nodular/tumoral lesions, were reviewed. Main outcome measures: Characterizing the macular lesions of low-grade PCBCL. Results: There were 14 patients, aged 16–67 years, 8 had PCFCL and 6 had primary cutaneous marginal zone lymphoma (PCMZL). All had erythematous macules, measuring 1–15 cm, which mimicked: figurate erythema, interstitial granuloma annulare, livedo reticularis, vascular tumors, and in 7 patients showed also follicular accentuation, thus simulated early-stage folliculotropic mycosis fungoides. In 3 patients macules were the presenting lesions, in 2 as the sole manifestation, whereas in 12 patients typical PCBCL lesions were observed during the disease course. On histopathology, the macular lesions showed in all superficial and deep perivascular infiltrates and in all but 1 also periadnexal lymphoid infiltrates. Microdules were observed in 11 biopsy specimens, in only 4 of them nodular infiltrates were also observed B-cells comprised the majority of the lymphocytes in only 4 patients, while in the remaining 10, B and T-cells were either equally distributed or T-cells outnumbered B. Polymerase-based analysis of a patch showed immunoglobulin heavy chain monoclonality in 7 of 11 cases tested. Con

关键词： squamous cell carcinoma of the penis   lymph node   extracapsular nodal extension   pN3   radiotherapy   #PenileCancer   #uroonc  

摘要： Objective To present the long-term adjuvant radiotherapy outcomes of patients with pN3 squamous cell carcinoma of the penis (SCCp) treated at two UK centres. Patients and Methods We conducted a retrospective audit of all pN3 SCCp patients, deemed suitable for adjuvant therapy by a specialist multidisciplinary team at St George's and Leeds Hospitals, who received adjuvant radiotherapy. Primary outcomes were recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). Secondary outcomes were time to adjuvant treatment, frequency of in-field recurrence, site and side of recurrence, and dose and schedule of radiotherapy. Results A total of 146 patients were included: 121 completed radiotherapy, four did not complete radiotherapy and 21 did not start it. The median (interquartile range [IQR]) age was 59 (54-70)years. The 5-year RFS was 51%, CSS was 51% and OS was 44%. Adjuvant radiotherapy was started at a median (IQR) of 75 (48-106) days. A dose of 45 Gy in 20 fractions was most commonly used. Of the 125 patients who started adjuvant treatment, 55 relapsed. Of these relapses, 30 occurred in an inguinal or pelvic nodal station and 26 of the 30 were in a radiation field. Relapses in 18 of the 55 cases were in visceral sites only and seven were in both nodal (non-irradiated sites) and visceral sites. Doses of <50 Gy were used more commonly before 2013 and higher doses (>50 Gy) were more commonly used after 2013. Conclusions Application of a standard radiotherapy protocol within a centralized supra-network setting has achieved survival outcomes that would appear better than those previously documented for either radiotherapy or chemotherapy in a cohort with solely pN3 disease. The addition of adjuvant chemotherapy may improve these outcomes further. These data suggest that adjuvant radiotherapy has a role to play in the management of men with pN3 SCCp.

关键词： Primary nephrotic syndrome   Children   B cells   Follicular helper T cells  

摘要： The immunopathogenesis of primary nephrotic syndrome is unclear. Here, we examined the frequency, subsets and molecular function of circulating B cells and follicular helper T cells by flow cytometry and explored the correlation between certain subsets and clinical disease indices in new-onset patients, relapsing patients and healthy controls. We found an increase in the proportions of CD86(+) activated cells and CD19(+)CD138(+) plasma cells in the patients at onset and patients in relapse. However, the increased percentage of CD27(+) memory cells was observed in only the relapse group. Furthermore, the ICOS MFI was elevated in TFH cells and their three subsets in new-onset patients, whereas the expression of OX40 was increased in TFH cells, TFH17 cells and TFH2 cells in the relapse group. Additionally, the increased frequency of CD19(+)CD138(+) plasma cells was positively associated with urea nitrogen in the new-onset groups. Notably, the positive correlation between CD86(+) activated B cells and CD19(+)CD138(+) plasma cells was obtained in only the new-onset group and HC group;however, the increased CD27(+) memory cell percentage was positively correlated with 24-h urinary protein in only the relapse group. Our results indicate that CD19(+)CD138(+) plasma cells may be a key factor for the onset of PNS, whereas CD27(+) memory cells may play a more important role in the relapse of this disease. Furthermore, the functions of TFH cells are also diverse because the expression of vital molecules changes during the different disease phases.

关键词： Thalassemia   CTLA-4   LAG-3   TIM-3   Alloimmunization   Regulatory T cells (Tregs)  

摘要： Alloimmunization is a serious complication in beta-thalassemia major patients as a result of repeated blood transfusion. The immune checkpoint receptors play an important role in regulating immune system homeostasis and the function of the immune cells. This study aimed to evaluate the expression of cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), lymphocyte activation gene 3 (LAG-3), and T-cell immunoglobulin and mucin domain-containing protein-3 (TIM-3) immune checkpoint molecules in beta-thalassemia major patients with and without alloantibody. For this purpose, 68 beta-thalassemia major patients with (34 patients) and without (34 patients) alloantibody as well as 20 healthy controls were enrolled. The expression of these genes was evaluated in different groups of patients by SYBR Green real-time PCR method. Our results showed that the mean expression of LAG-3 was significantly increased in thalassemia patients compared to the control group (*P < 0.001). However, there was no significant difference in expression of the CTLA-4 and TIM-3 as well as LAG-3 genes between patients with and without alloantibody (P > 0.05). A positive correlation was observed between the level of LAG-3 expression with markers associated with Treg function including FOXP3 and GDF-15 genes in beta-thalassemia major patients. Taken together, the LAG-3 molecule might have a more prominent role in the abnormality of the immune system in thalassemia patients especially the function of regulatory T cells (Tregs), prior to the CTLA-4 and TIM-3 genes.

关键词： anomaly-based IDS   IoT architecture mapping   deep learning   machine learning (ML)   intrusion-detection systems (IDS)   IoT security  

摘要： This paper surveys the deep learning (DL) approaches for intrusion-detection systems (IDSs) in Internet of Things (IoT) and the associated datasets toward identifying gaps, weaknesses, and a neutral reference architecture. A comparative study of IDSs is provided, with a review of anomaly-based IDSs on DL approaches, which include supervised, unsupervised, and hybrid methods. All techniques in these three categories have essentially been used in IoT environments. To date, only a few have been used in the anomaly-based IDS for IoT. For each of these anomaly-based IDSs, the implementation of the four categories of feature(s) extraction, classification, prediction, and regression were evaluated. We studied important performance metrics and benchmark detection rates, including the requisite efficiency of the various methods. Four machine learning algorithms were evaluated for classification purposes: Logistic Regression (LR), Support Vector Machine (SVM), Decision Tree (DT), and an Artificial Neural Network (ANN). Therefore, we compared each via the Receiver Operating Characteristic (ROC) curve. The study model exhibits promising outcomes for all classes of attacks. The scope of our analysis examines attacks targeting the IoT ecosystem using empirically based, simulation-generated datasets (namely the Bot-IoT and the IoTID20 datasets).

关键词： Primary cutaneous B-cell lymphomas   epidemiology   pediatric dermatology  

摘要： Background: The incidence of primary cutaneous B-cell lymphomas (PCBCL) in the pediatric population is unknown, and the information on pediatric PCBCL has mostly been gathered from individual case reports or series from single centers. Objective: To assess the incidence of PCBCL in the pediatric population (<20 years) compared with adult patients (≥20 years) and delineate its demographic and clinicopathologic characteristics. Methods: This was a population-based, retrospective cohort study of patients in 18 cancer registries in the United States diagnosed between 2000 to 2016 through the Surveillance, Epidemiology, and End Results (SEER) program. Age-adjusted incidence rates were calculated for PCBCL in pediatric and adult populations. Demographic, clinical, and pathological characteristics were compared between the two groups. Results: 5,128 adult and 48 pediatric PCBCL cases were included. The median age at diagnosis in the pediatric group was 16.5 years. The major histologic subtypes of pediatric cases were marginal zone lymphoma (77.1%), diffuse large B-cell lymphoma (12.5%) and follicle center lymphoma (10.4%), which significantly differed from the distribution in the adult group (p<0.001) where subtypes were equally distributed. The age-adjusted pediatric PCBCL incidence rate (per 1,000,000 person‐years) was 0.12 (95% CI 0.09-0.16) and incidence in the adult population was approximately 40-fold higher (IRR 41.4, 95% CI 31.2-56.2, P<0.001). All 48 pediatric cases were alive during a median follow-up time of 48 months. Conclusions: Pediatric PCBCL is a rare and indolent disease, which affects mostly adolescents of both sexes. Clinical presentation is similar to adults, but marginal zone subtype is significantly over-represented.

关键词： Health-related quality of life  

摘要： Background: Health-related quality of life (HRQoL) in patients with cutaneous lymphoma (CL) is negatively impacted by a large burden of disease symptoms including intractable itch, pain, discomfort and socially stigmatising cosmetic disfigurement which may adversely affect patient self-esteem and interpersonal relationships. There is currently no cure for CL and as such, accurate determination of patient HRQoL is of paramount importance. To date, the impact of both skin disease and of a cancer diagnosis on patient HRQoL in CL is assessed using separate, non-CL-specific questionnaires. A composite HRQoL questionnaire addressing all aspects of the disease is lacking. Methods: The EORTC Quality of Life Group questionnaire development guidelines were followed. For phase I, semi-structured interviews were conducted in 15 patients with early-stage mycosis fungoides (IA–IIA), 30 patients with late-stage mycosis fungoides/Sézary syndrome (IIB–IVB) (15 patients <3 years and >3 years from diagnosis) and 15 patients with cutaneous B cell lymphoma. Collaborators communicated during the patient recruitment to ensure balanced patient selection with respect to age, gender, stage, duration of the disease, and number of (previous) treatments. Results: Patients were recruited in 5 countries (6 centres) across Europe. So far, 62 patients participated (target 60) from each of the following representative patient groups: early MF (stage IA–IIA), late MF (stage IIB–IVB) and cutaneous B cell lymphoma. Data from patient interviews and questionnaires is being analyzed using basic quantitative analyses, including generation of descriptive statistics (e.g., %missing data, means and standard deviations, floor and ceiling effects, etc.), prevalence (number of patients who experienced each complaint i.e. who scored 2, 3 or 4, divided by the total number of patients who completed that item, multiplied by 100), priority ratings (number of patients and professionals who have given priority ratings

关键词： Lymphocytes   Medical research   Medicine/Public Health   general   Internal Medicine   Intensive / Critical Care Medicine   Cancer Research   Oncology   Hematology