Diagnosis and treatment of passenger lymphocyte syndrome following secondary ABO-incompatible allogeneic hematopoietic stem cell transplantation / 中国输血杂志

【Objective】 To investigate the clinical characteristics and diagnosis and treatment of passenger lymphocyte syndrome (PLS) in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT). 【Methods】 A total of 489 patients who underwent allo-HSCT in Suzhou Hongci Hematology Hospital were retrospectively enrolled. The clinical process, diagnosis and treatment measures and prognosis of four patients complicated with PLS after transplantation were analyzed. 【Results】 Among the 489 patients, 4 were diagnosed with PLS. The blood types of donor/recipient ABO were all secondary incompatible (The blood type of donors were O and the recipients were A or B). The overall incidence of PLS in allo-HSCT was 0.82%(4/489)and 2.2%(4/179)in transplants with donor/recipient secondary incompatible ABO-blood types. PLS occured in 6-13 days after donor stem cell infusion. Clinical manifestations were dizziness and fatigue, low back pain, jaundice, deepening urine, rapid decrease in hemoglobin on laboratory tests, elevated indirect bilirubin and lactate dehydrogenase, positive urobilinogen, positive direct anti-human globulin test (DAT), and anti-A or anti-B antibodies against recipient red blood cells were detected in plasma. After the treatment of O-type washed red blood cells, methylprednisolone, gamma globulin, rituximab and other treatments, the hemolysis was improved. All patients achieved engraftment of neutrophil and platelet. Red blood cell transfusion was halted in 3 weeks. 【Conclusion】 PLS is a rare complication of allo-HSCT, which mainly occurs in allo-HSCT patients with secondary incompatibility of ABO blood group of donor/recipient. The clinical prognosis is good after properly treatment.

Establishment and validation of a risk prediction model for portal vein thrombosis in liver cirrhosis by nomogram / 中华消化内镜杂志

Objective:To explore the independent risk factors of portal vein thrombosis (PVT) in liver cirrhosis, and to establish and evaluate a risk prediction model for PVT in patients with cirrhosis.Methods:A total of 295 cases of cirrhosis hospitalized in Renmin Hospital of Wuhan University from December 2019 to October 2021 were divided into a modeling set ( n=207) and an internal validation set ( n=88) by the random number table. In addition, patients with cirrhosis hospitalized in Yichang Central People's Hospital, Wuhan Puren Hospital, No.2 People's Hospital of Fuyang City and People's Hospital of China Three Gorges University during the same period were collected as an external validation set ( n=92). The modeling set was divided into PVT group ( n=56) and non-PVT group ( n=151). Univariate analysis was used to preliminarily screen the related indicators of PVT, and then multivariate logistic regression analysis with forward stepwise regression was used to determine independent risk factors for PVT. A nomogram prediction model was constructed based on the independent risk factors obtained. The internal and external validation set were used to verify the predictive ability of the model. Distinction degree was used to evaluate the ability of the model to distinguish patients with or without PVT. Hosmer-Lemeshow goodness-of-fit test was used to evaluate the consistency between predicted risk and the actual risk of the model. Results:Univariate analysis showed that smoking, history of splenectomy, trans-jugular intrahepatic portosystemic shunt (TIPS), gastrointestinal bleeding and endoscopic variceal treatment, and levels of hemoglobin, alanine aminotransferase, aspartate aminotransferase and D-dimer were significantly different between the PVT group and the non-PVT group ( P<0.05). Multivariate logistic regression analysis found that smoking ( P=0.020, OR=31.21, 95% CI: 1.71-569.40), levels of D-dimer ( P=0.003, OR=1.12, 95% CI: 1.04-1.20) and hemoglobin ( P=0.039, OR=0.99, 95% CI: 0.97-1.00), history of TIPS ( P=0.011, OR=18.04, 95% CI: 1.92-169.90) and endoscopic variceal treatment ( P=0.001, OR=3.21, 95% CI: 1.59-6.50) were independent risk factors for PVT in patients with liver cirrhosis. Receiver operator characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) for the internal validation set was 0.802 (95% CI: 0.709-0.895) ( P<0.001), and the AUC for the external validation set was 0.811 (95% CI: 0.722-0.900) ( P<0.001). Both AUC were larger than 0.75. The calibration curve of Hosmer-Lemeshow goodness-of-fit test showed that the P values of both internal validation set ( χ2=3.602, P=0.891) and the external validation set ( χ2=11.025, P=0.200) were larger than 0.05. Conclusion:Smoking, history of TIPS or endoscopic variceal treatment, levels of D-dimer and hemoglobin are independent risk factors for PVT in patients with liver cirrhosis. The prediction nomogram model based on the above factors has strong predictive ability.

Safety evaluation of thymectomy in elderly patients aged 65 years and over / 中华老年医学杂志

Objective:To evaluate the safety of thymic surgery in patients aged 65 years and over.Methods:A total of 696 patients who underwent thymectomy/thymoma resection in the Department of Thoracic Surgery of Beijing Hospital from November 2011 to March 2022 were collected and divided into two groups according to the age of 65 years old.The preoperative course of disease, MG stage, dosage of pyridostigmine bromide, American College of Anesthesiologists(ASA)score, surgical method, intraoperative bleeding, postoperative drainage, postoperative complications, Clavien-dindo score(CDC), and myasthenic crisis were recorded and statistically analyzed.Results:A total of 696 patients were enrolled, including 364 males and 332 females, aged 15~86 years, with an average age of 49.1 years.There were 309 patients with thymoma, 565 patients with MG, and 178 patients with both.There were 124 cases in the elderly group(≥65 years old)and 572 cases in the non-elderly group(<65 years old). The incidence of thymoma was higher in the elderly group(54.8 % versus 42.1 %, χ2=6.664, P=0.010), while the incidence of MG was lower(67.7 % versus 84.1 %, χ2=17.827, P<0.001). The ASA score of the elderly group was higher than that of the non-elderly group( χ2=52.372, P=0.000), and the preoperative ventilation function FEV1 and FEV1/FVC were also significantly lower than those of the non-elderly group( z=8.187, 4.580, P=0.000 for all). The drainage volume in the first 3 days after operation and postoperative drainage tube time in the elderly group were significantly higher than those in the non-elderly group( P=0.018, P=0.003). The incidence of postoperative myasthenia crisis in the elderly group was higher than that in the non-elderly group( P=0.034). There was no significant difference in the incidence of postoperative complications between the two groups, but after Clavien-dindo classification, the score of the elderly group was higher than that of the non-elderly group( P=0.003). Although the ASA score and Clavien-dindo score of the elderly group were both higher than those of the non-elderly group, there was no correlation between the two. Conclusions:Although the preoperative ASA score and pulmonary function of elderly patients were poorer than those in the non-elderly group, while the incidence of postoperative myasthenia crisis was higher, and the incidence of postoperative complications was not higher, the Clavien-dindo classification, however, was higher in elderly patients than that of the non-elderly group.After careful preoperative evaluation and strengthening perioperative management, most elderly patients can receive thymus surgery safely with acceptable risks.

Application and progress of 99Tc m-GSA and 99Tc m-mebrofenin hepatobiliary scintigraphy in liver reserve function assessment / 中华核医学与分子影像杂志

The liver reserve function refers to the compensatory ability to maintain liver function after damage, providing implication for the resection of hepatic malignant tumor. Hepatobiliary scintigraphy imaging can provide quantitative evaluation of liver blood perfusion, and has advantages on the evaluation of liver reserve function and the prediction of postoperative complications. 99Tc m-galactosyl serum albumin (GSA) and 99Tc m-mebrofenin are commonly used imaging agents for hepatobiliary scintigraphy imaging assessment of liver reserve function. This article reviews the application and progress of hepatobiliary scintigraphy in liver reserve function assessment.

Optimization of extraction process of prescription medicinal materials of compound Yangshe granules / 药学实践杂志

Objective Optimizing the extraction process of prescription medicinal materials of hospital preparation of compound Yangshe granules. Methods A high performance liquid chromatograph (HPLC) quantitative method was established for deacetyl asperulosidicacid methyl ester (DME) and ferulic acid (FC) of the active ingredient. Based on the content of DME, FC and the yield of extract, the extraction process of compound Yangshe granule extract was optimized using central composite design-response surface methodology. Results The established HPLC method of quantification of active components in compound Yangshe granules met the requirements of method validation. The optimal extraction process optimized by central composite design-response surface methodology were as follows: the weight of extraction solvent was 12 times of the medicinal slices, the alcohol concentration was 73% and the extraction time was 60 min. Conclusion In this study, the quantitative method of active components in compound Yangshe granule by HPLC has been successfully established, and the optimized extraction process is simple and easy to operate with good repeatability.

Rhodojaponin VI indirectly targets Cav2.2 channels via N-ethylmaleimide-sensitive fusion protein to alleviate neuropathic pain

Neuropathic pain is a chronic disease that severely afflicts the life and emotional status of patients, but currently available treatments are often ineffective. Novel therapeutic targets for the alleviation of neuropathic pain are urgently needed. Rhodojaponin VI, a grayanotoxin from Rhododendron molle, showed remarkable antinociceptive efficacy in models of neuropathic pain, but its biotargets and mechanisms are unknown. Given the reversible action of rhodojaponin VI and the narrow range over which its structure can be modified, we perforwmed thermal proteome profiling of the rat dorsal root ganglion to determine the protein target of rhodojaponin VI. N-Ethylmaleimide-sensitive fusion (NSF) was confirmed as the key target of rhodojaponin VI through biological and biophysical experiments. Functional validation showed for the first time that NSF facilitated trafficking of the Cav2.2 channel to induce an increase in Ca2+ current intensity, whereas rhodojaponin VI reversed the effects of NSF. In conclusion, rhodojaponin VI represents a unique class of analgesic natural products targeting Cav2.2 channels via NSF.

Clinical efficacy of da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis / 中华消化外科杂志

Objective:To investigate the clinical efficacy of da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 7 patients who underwent da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis in Xinjiang Uiger Municipal People′s Hospital from October 2019 to July 2021 were collected. There were 3 males and 4 females, aged (43±12)years. Observation indicators: (1) surgical situations; (2) complications; (3) follow-up. Mea-surement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations. All 7 patients underwent da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis successfully, without conversion to laparotomy and laparoscopic surgery. None of the 7 patients underwent intraoperative blood transfusion and the operation time, volume of intraoperative blood loss, time to postoperative first and flatus, time to postoperative initial liquid food intake, time to postoperative abdominal drainage tube removal, time to postoperative urethral catheter removal, duration of postoperative hospital stay of 7 patients was (225±45)minutes, 100(range, 50-200)mL, (1.9±0.7)days, (4.2±1.2)days, (7±4)days, (2.9±0.8)days, (7±4)days, respectively. (2) Complications. None of the 7 patients had postoperative complications such as bile leakage, abdominal hemorrhage, incision infection, hydatid cavity infection, secondary operation, intestinal obstruction, pulmonary infection and deep venous thrombosis of lower limbs. (3) Follow-up. All 7 patients were followed up for 7 (range, 3-12) months. None of the 7 patients had recurrence of hepatic echinococcosis or peritoneal implantation and incision implantation, and all patients survived during follow-up.Conclusion:da Vinci Xi surgical system assisted laparoscopic exocytosis for hepatic echinococcosis is safe and feasible.

Application value of manual anastomosis of gastroduodenum in totally laparoscopic distal gastrectomy / 中华消化外科杂志

Objective:To investigate the application value of manual anastomosis of gastro-duodenum in totally laparoscopic distal gastrectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 55 patients with gastric cancer who underwent totally laparoscopic distal gastrectomy combined with gastrointestinal anastomosis in the Tianjin Medical University Cancer Institute & Hospital from January 2020 to October 2022 were collected. There were 34 males and 21 females, aged 61(range, 29?75)years. Of 55 patients, 25 patients undergoing manual anastomosis of gastroduodenum were divided into the manual anastomosis group, 30 patients undergoing modified Delta anastomosis of gastroduodenum were divided into the modified Delta anastomosis group. Observation indicators: (1) surgical situations; (2) postoperative complications. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers, and comparison between groups was conducted using chi-square test or Fisher exact probility. Results:(1) Surgical situations. All 55 patients underwent surgery successfully, without conversion to laparotomy. The distance from the superior margin of tumor to the upper margin, anastomosis time, number of bookings used were (48±4)mm, (22.6±2.3)minutes, 3.2±0.5 in the manual anastomosis group, versus (41±4)mm, (14.0±1.4)minutes, 5.2±0.4 in the modified Delta anastomosis group, showing significant differences in the above indicators between the two groups ( t=5.04, 16.38, ?17.13, P<0.05). The location of tumor (antrum, gastric angle) was 18, 7 in the manual anastomosis group, versus 29, 1 in the modified Delta anastomosis group, showing a significant difference between the two groups ( P<0.05). (2) Postoperative complications. There was no patient undergoing anastomotic fistula in both of manual anastomosis group and modified Delta anastomosis group, and there was 1 patient undergoing anastomotic stenosis in the modified Delta anastomosis group. Conclusion:Compared with modi-fied Delta anastomosis of gastroduodenum,totally laparoscopic distal gastrectomy with manual anas-tomosis of gastroduodenum can remove more gastric tissue, and decrease the number of bookings used.

Association of UGT1A1 gene G71R polymorphism with neonatal hyperbilirubinemia / 中国小儿急救医学

Objective:To explore the association between the G71R polymorphism of the UGT1A1 gene and neonatal hyperbilirubinemia. Methods:DNA was extracted from blood samples of 61 neonates with severe neonatal hyperbilirubinemia(severe neonatal hyperbilirubinemia group), 60 neonates with hyperbilirubinemia(hyperbilirubinemia group) and 62 healthy neonates(control group), the G71R mutation of UGT1A1 gene was analyzed by direct sequencing. Results:In severe neonatal hyperbilirubinemia group, there were 17 cases of homozygous mutation(A/A), 23 cases of heterozygous mutation(A/G) , and 21 cases of wild type(G/G) , with 28.87% homozygous mutation rate and 37.70% heterozygous mutation rate.In neonatal hyperbilirubinemia group, there were ten cases of homozygous mutation(A/A), 28 cases of heterozygous mutation(A/G) and 22 cases of wild type(G/G), with 16.67% homozygous mutation rate and 46.67% heterozygous mutation rate.In the control group, there were nine cases of homozygous mutation (A/A), 28 cases of heterozygous mutation(A/G) and 25 cases of wild type(G/G), among which the homozygous mutation rate was 14.52% and the heterozygous mutation rate was 45.16%.The genotype frequency( χ2=4.14, P=0.38)and allele frequency( χ2=2.47, P=0.29)of G71R in severe neonatal hyperbilirubinemia group, neonatal hyperbilirubinemia group and control group were not statistically significant. Conclusion:The G71R polymorphism of the UGT1A1 gene may not be significantly correlated with the prevalence of neonatal hyperbilirubinemia.

Tislelizumab bridging to umbilical cord blood transplantation therapy for relapsed/refractory acute myeloid leukemia: report of 1 case and review of literature / 白血病·淋巴瘤

Objective:To explore the efficacy of tislelizumab combined with umbilical cord blood transplantation (UCBT) in relapsed/refractory acute myeloid leukemia (R/R AML) patients.Methods:The diagnosis and treatment of 1 patient with R/R AML who received tislelizumab bridging to UCBT after the failure of re-induction treatment in the First Affiliated Hospital of Soochow University in November 2021 was retrospectively analyzed.Results:The 59-year-old male patient with R/R AML achieved a complete remission after initial induction chemotherapy regimen of decitabine and venetoclax, and then additional consolidation therapy regimens of decitabine and middle-dose cytarabine, middle-dose cytarabine and idarubicin were performed. The patient relapsed 16 months later and failed to achieve a second remission after re-induction therapy regimens of cladribine, azacitidine, venetoclax combined with chemotherapy, and homoharringtonine, cytarabine combined with granulocyte colony-stimulating factor. Tislelizumab significantly reduced tumor burden and the patient achieved the complete remission after bridging to UCBT. After transplantation, the patient was given maintenance treatment with azacitidine and he had sustained remission without severe transplant-related complications during 9-month follow-up.Conclusions:The use of tislelizumab bridging UCBT can be a potential therapeutic strategy for R/R AML patients.

LncRNA SBF2-AS1 Regulates Invasion and Proliferation of Hepatocellular Carcinoma Cells Through miR-372-3p/CDK6 Axis / 肿瘤防治研究

Objective To investigate the effects of lncRNA SBF2-AS1 on the proliferation and invasion of hepatoma cells by regulating the miR-372-3p/CDK6 pathway. Methods Bel7402 and SK-hep1 cells were selected as research objects. The expression levels of SBF2-AS1, miR-372-3p, and CDK6 were up- or down-regulated according to different experimental stages, while the expression levels of miR-372-3p and CDK6 in cells were detected by real-time fluorescence quantitative PCR and Western blot. Dual luciferase reporter assay verified the targeting relationships between SBF2-AS1 and miR-372-3p as well as miR-372-3p and CDK6, respectively. CCK-8, colony formation assay, Transwell, cell cycle assay, and flow cytometry were used to analyze cell proliferation, colony formation, migration/invasion ability, cell cycle activity, and apoptosis. Results SBF2-AS1 was highly expressed in hepatocellular carcinoma cells (P<0.05). SBF2-AS1 knockdown resulted in decreased proliferation and invasion of Bel7402 and SK-hep1 cells (P<0.05). After miR-372-3p knockdown, the proliferation capacity and invasion number of Bel7402 cells were significantly increased. However, the above results were reversed after SBF2-AS1 knockdown (P<0.05). In addition, miR-372-3p targeted CDK6 and inhibited its expression, although over-expressing SFB2-AS1 could reverse the above results (P<0.05). Over-expressing CDK6 could reverse the inhibition of over-expressing miR-372-3p on the proliferation and invasion of Bel7402 cells. Conclusion LncRNA SBF2-AS1 can positively regulate the expression of CDK6 through miR-372-3p. It can also influence the distribution of cell cycle and affect the proliferation and invasion abilities of hepatocellular carcinoma cells.

Relationship between the gross motor function classification system and hip and lumbar spine development in children with spastic cerebral palsy / 中国骨伤

OBJECTIVE@#To investigate the relationship among the gross motor function classification system (GMFCS)and the development of hip joint and lumbar spine in children with spastic cerebral palsy.@*METHODS@#The clinical data of 125 children with spastic cerebral palsy admitted from January 2018 to July 2021 were retrospectively analyzed. There were 85 males and 40 females, aged from 4 to 12 years old with an average of (8.4±2.9) years. According to GMFCS, the patients were divided into gradeⅠ, Ⅱ, Ⅲ and Ⅳ groups. There were 27 cases in gradeⅠgroup, 40 cases in gradeⅡgroup, 35 cases in grade Ⅲ group and 23 cases in grade Ⅳ group. The migration percentage(MP), central edge angle(CE), neck-shaft angle(NSA), acetabular index(AI) were measured by the radiograph of pelvis, abnormal parameters were selected to evaluate the relationship between different GMFCS grades and hip joint development. Lumbar sagittal Cobb angle, lumbar sacral angle, lumbar lordosis index and apical distance were measured by lateral lumbar radiographs to evaluate the relationship between different GMFCS grades and lumbar spine development.@*RESULTS@#①Among the 125 spastic cerebral palsy children, there were 119 cases of pelvic radiographs that met the measurement standards. In the four groups with gradeⅠ, Ⅱ, Ⅲ, Ⅳ, MP was (22.72±3.88), (26.53±4.36), (33.84±4.99), and (49.54±7.87)%, CE was(30.10±6.99) °, ( 22.92±4.19) °, ( 17.91±5.50) °, and (-0.70±17.33)°, AI was (16.41±2.77) °, (20.46±4.63) °, (23.76±5.10) °, and ( 29.15±7.35)°, respectively, there were significant differences between the two comparisons (P<0.05). And the higher GMFCS grade, the greater MP and AI, and the smaller CE.The NSA was(142.74±10.03) °, (148.66±9.09) °, (151.66±10.52) °, and (153.70±8.05)° in four groups with gradeⅠ, Ⅱ, Ⅲ, Ⅳ, respectively. The differences between the two comparisons of the GMFCS gradeⅠgroup and the other three groups were statistically significant (P<0.05). NSA of GMFCSⅠgroup was significantly lower than that of the others, there was no significant difference among other groups(P>0.05). ② Among the 125 spastic cerebral palsy children, there were 88 cases of lumbar spine radiographs that met the measurement standards. ③The lumbar sagittal Cobb angle was(32.62±11.10) °, (29.86±9.90) °, (31.70±11.84) °, and (39.69±6.80)° in the four groups with gradeⅠ, Ⅱ, Ⅲ, Ⅳ, respectively;GMFSS of grade Ⅳ group was significantly higher than that of other three groups, there was significant difference between the two comparisons (P<0.05);there were no significant differences between other groups (P>0.05). In the four groups with gradeⅠ, Ⅱ, Ⅲ, Ⅳ, the lumbosacral angle was (31.02±9.91) °, ( 26.57±9.41) °, (28.08±8.56) °, and ( 27.31±11.50)°, the lumbar lordosis index was (4.14±12.89), (8.83±13.53), (13.00±11.78), and (10.76±9.97) mm, the arch apex distance was (9.50±6.80), (6.68±3.20), (7.16±4.94), and (6.62±4.13) mm, respectively, there were no significant differences between the two comparisons(P>0.05).@*CONCLUSION@#①In children with GMFCS gradeⅠ-Ⅳ, the higher the GMFCS grade, the worse the hip develops. ② Children with GMFCS grade Ⅲ-Ⅳ may be at greater risk for lumbar kyphosis.

Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients (version 2022) / 中华创伤杂志

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.

The clinical outcomes of elderly acute leukemia patients receiving allogenic hematopoietic stem cell transplantation and application of comprehensive nursing care / 中国输血杂志

【Objective】 To investigate the clinical outcomes of allogeneic hematopoietic stem cell transplantation in elderly patients with acute leukemia and the role of comprehensive nursing. 【Methods】 The data of 52 elderly patients with acute leukemia during the treatment of allogeneic hematopoietic stem cell transplantation were collected. According to the characteristics of elderly patients, 52 patients were given comprehensive nursing measures such as psychological, protective isolation, dietary management and specialized nursing. Stem cell engraftment, transplant complications and survival rates were observed in patients with comprehensive nursing support. 【Results】 All patients received comprehensive care. Of the 52 patients, 49 (94.2%) achieved neutrophil engraftment, with a median engraftment time of 12 days (9~19 days), and 45 patients (86.5%) achieved platelet engraftment with a median engraftment time of 13 days (9~35 days). The cumulative incidence of Ⅱ-Ⅳ°acute graft-versus-host disease (GVHD) was 26.9%, and the cumulative incidence of chronic GVHD was 28.5%. Cytomegalovirus (CMV) infection occurred in 15 cases, with a cumulative incidence rate of 37.5%, and Epstein-Barr virus (EBV) infection occurred in 5 cases, with a cumulative incidence rate of 9.9%. Bloodstream bacterial infection occurred in 8 patients with a cumulative incidence of 9.6%. With a median follow-up of 226 days (71~2 365 days), 39 patients survived and 13 died. The 1-year overall survival (OS) was 71.4%, and the OS and disease free survival (DFS) of patients with negative minimal residual disease (MRD) were both 100%. OS and DFS in MRD positive group were 59.2% and 48.1%, respectively. 【Conclusion】 Elderly patients with acute leukemia who receive allogeneic hematopoietic stem cell transplantation can also achieve long-term survival. Taking targeted preventive and nursing measures can ensure the success rate of transplantation.

The pivotal role of autophagy in bone cells:bone-related cell activity and bone metabolism / 中国组织工程研究

BACKGROUND:The importance of autophagy for maintaining cellular homeostasis and stress response has long been recognized.As a way for cells to selectively clear their damaged organelles to achieve the recycling of cellular components,autophagy has a pivotal role in bone metabolism.OBJECTIVE:To review the role and possible mechanisms of autophagy in regulating bone-related cell activity and function among bone marrow mesenchymal stem cells,osteoblasts,osteocytes,and osteoclasts.METHODS:PubMed was searched for studies related to autophagy using the keywords of "autophagy;bone marrow mesenchymal stem cells;osteoblasts;osteocytes;osteoclasts."RESULTS AND CONCLUSION:We finally included 84 papers.Autophagy plays an important role in bone metabolism.Autophagy is involved in maintaining the balance between mineralization and absorption,and then maintaining bone homeostasis.An appropriate autophagy inducer may also benefit bone remodeling.Abnormal autophagy can lead to disorders of bone balance,leading to diseases such as osteoporosis.We may prevent or treat bone-related diseases by regulating the level of autophagy as its function in maintaining the balance of mineralization and resorption in bone homeostasis.

Research advances in microRNA-200c in pancreatic cancer / 临床肝胆病杂志

MicroRNA-200c (miR-200c) is a type of non-coding small molecule RNA, which is involved in the post-transcriptional regulation of genes and is closely associated with the development and progression of tumor. This article introduces the inhibitory effect of miR-200c on the invasion and metastasis of pancreatic cancer and the clinical application value of miR-200c in the early diagnosis and prognostic evaluation of pancreatic cancer. It is pointed out that miR-200c can be used as a tumor suppressor gene and an effective molecular marker for further clinical research.

Successful Rescue of Acute Exacerbation of Idiopathic Pulmonary Fibrosis after Surgery for Lung Cancer: Case Report / 中国肺癌杂志

Idiopathic Pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic interstitial lung disease with unknown cause, which is closely related to lung cancer. A serious complication called Acute exacerbation of IPF (AE-IPF) is prone to occur after lung resection. It progresses rapidly without effective treatment and has a poor prognosis. A typical case of AE-IPF after lung cancer surgery was reported, and its clinical characteristics, imaging features, diagnosis and treatment were summarized.
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Research on gait recognition and prediction based on optimized machine learning algorithm / 生物医学工程学杂志

Aiming at the problems of individual differences in the asynchrony process of human lower limbs and random changes in stride during walking, this paper proposes a method for gait recognition and prediction using motion posture signals. The research adopts an optimized gated recurrent unit (GRU) network algorithm based on immune particle swarm optimization (IPSO) to establish a network model that takes human body posture change data as the input, and the posture change data and accuracy of the next stage as the output, to realize the prediction of human body posture changes. This paper first clearly outlines the process of IPSO's optimization of the GRU algorithm. It collects human body posture change data of multiple subjects performing flat-land walking, squatting, and sitting leg flexion and extension movements. Then, through comparative analysis of IPSO optimized recurrent neural network (RNN), long short-term memory (LSTM) network, GRU network classification and prediction, the effectiveness of the built model is verified. The test results show that the optimized algorithm can better predict the changes in human posture. Among them, the root mean square error (RMSE) of flat-land walking and squatting can reach the accuracy of 10 -3, and the RMSE of sitting leg flexion and extension can reach the accuracy of 10 -2. The R 2 value of various actions can reach above 0.966. The above research results show that the optimized algorithm can be applied to realize human gait movement evaluation and gait trend prediction in rehabilitation treatment, as well as in the design of artificial limbs and lower limb rehabilitation equipment, which provide a reference for future research to improve patients' limb function, activity level, and life independence ability.

Acute interstitial pneumonia in elderly patients after thoracic surgery: a report of 5 cases and literature review / 中华老年医学杂志

Objective:To analyze the clinical characteristics of elderly patients with acute interstitial pneumonia after thoracic surgery, and to provide evidence for the diagnosis and treatment of acute interstitial pneumonia after surgery.Methods:Data from 2578 elderly patients who had undergonethoracic surgery at Beijing Hospital from October 2014 to October 2021were collected.Five patients developed acute interstitial pneumonia after thoracic surgery.The diagnosis and treatment of the patients were analyzed and major relevant issues were discussed in combination with the literature.Results:Of the 5 patients aged from 60 to 74 years, including 4 men and 1 woman, 3 had idiopathic pulmonary interstitial fibrosis and 2 had Sjogren's syndrome with secondary pulmonary interstitial fibrosis.Preoperative chest CT images were characterized by sporadic interlobular septal thickening and ground-glass, reticular and linear opacities in both lungs.After surgery, all 5 patients presented unexplained and progressively aggravating dyspnea in 1~3 days and chest imaging showed newly emerged and more diffuse ground-glass, reticular and linear opacities in both lungs, in addition toprevious pulmonary interstitial fibrosis.Four patients were treated with glucocorticoids, and four underwent endotracheal intubation and mechanical ventilation.Two cases were treated successfully, 1 case improved after treatment but died after re-aggravation, and 2 cases died after treatment failure.Conclusions:Patients with pulmonary interstitial fibrosis after thoracic surgery may have progressive and aggravated dyspnea in the early postoperative period.Early CT imaging and pathogenic examinations will be helpful in differential diagnosis.Acute interstitial pneumonia often involves both lungs, with rapid progression and high mortality.Once the disease has progressed to respiratory failure, mechanical ventilation should be initiated as early as possible to improve organ function.Glucocorticoids should be used early with sufficient doses and lengths to prevent re-aggravation.

Clinical characteristics in elderly patients with thymic epithelial tumors and prognostic analysis of more than 3 years postoperative follow-up / 中华老年医学杂志

Objective:To evaluate the clinical characteristics and the surgical safety in patients aged 65 years and over with thymic epithelial tumor, and analyze the prognosis of 3-10 years postoperative tumor and myasthenia gravy.Methods:A total of 228 patients diagnosed as thymic tumor and undergoing surgical surgery to remove the tumor in Beijing Hospital from Jan.2011 to Dec.2018 were retrospectively enrolled.Patients were divided into a young(≤ 65 yrs)and old(>65 yrs)groups.The operation time, intra-operative bleeding, drainage volume in the first 3 days after operation, days with drainage tube after operation, postoperative days of hospital stays, the diameter of the tumors, pathological classification, Tumor-Node-Metastasis(TNM)staging, Masaoka-Koga staging, whether or not complicated with myasthenia gravis and complications were compared between two groups.The patients were followed up by outpatient or telephone, and recurrence of thymoma, survival status and improvement of myasthenia gravis were tracked.Results:There were significant differences in pathological classification between the two groups( P=0.002). The postoperative days with drainage tube were longer in patients≥65 years old than in patients<65 years old[4(2-17)days and 3(1-9), Z=2.316, P=0.021]. Thymic atrophy was more common in patients ≥ 65 years old than in patients <65 years old(10.2% and 1.7%, χ2=5.937, P=0.015). Incidence of thymoma plus myasthenia gravis were higher in patients aged <65 years than those aged ≥65years(68.2% vs.40.8%, χ2=12.240, P<0.001), and incidence of thymic hyperplasia were higher in patients aged <65 years than those aged ≥65years(58.1% and 38.8%, χ2=2.316, P=0.016). The recurrence of thymoma was a poor prognostic factor affecting the survival of patients.Meanwhile, Masaoka-Koga stage Ⅲ and Ⅳ and TNM stage Ⅲ and Ⅳ were independent risk factors for postoperative recurrence of thymoma. Conclusions:Thymectomy is safe and effective in the patients aged 65 and over, and may have a better long-term prognosis.