With the application of novel agents and high-dose chemotherapy with autologous stem cell transplantation(ASCT),the survival time of multiple myeloma(MM) has been significantly prolonged.However,due to the biological characteristics of myeloma and minimal residual disease after initial treatment,the disease courses of most MM patients show a series of remissions and relapses.Hence,it is necessary to apply consolidation and maintenance therapy after ASCT and continuous therapy for transplant-ineligible patients.This paper reviews the advances in consolidation,maintenance and continuous therapy for MM in the era of novel agents.

Regulatory T (Treg) cells are a group of cells with immunosuppressive function which play important roles in tumor immunity.This paper reviews the advances of Treg cells in multiple myeloma (MM),including the basic characteristics of Treg cells,interaction of Treg cells and myeloma cells,influences of antimyelona treatnent on Treg cells.

As the introduction of novel agents,the median overall survival of elderly newly diagnosed multiple myeloma patients has increased roughly from 30 to 60 months.But patients with high risk prognostic features still have a poor clinical outcome.This paper which combined the 19th annual congress of the European Hematology Association (EHA) reviews the advances in elderly patients with newly diagnosed multiple myeloma,including standard of care,the way to treatment and prognostic factors.

Objective To observe the implementation of national food safety standard for “Iodine Concentration in Edible Salt”(GB 26878-2011) and its effectiveness on iodine nutritional status of key populations. Methods Information of iodine concentration in edible iodized salt of various provinces (autonomous regions and municipalities, including Xinjiang Production and Construction Corps) was collected using Baidu Searching Engine through the establishment of key words. Sal t samples were collected in Tianjin City and Aksu Region of Xinjiang , and the salt iodine concentration in both places was 30 mg/kg. In Tianjin, Hongqiao, Tanggu and Hangu, Beichen were selected as representatives of the downtown areas, the coastal areas and the suburbs, respectively and counties of Baodi and Ji were iodine deficiency areas in history. Sampling work was carried out from August 2012 to March 2013 in Tianjin. In Aksu, Yatuoer Township and Charqi Town in Baicheng County, Aotebeixi and Aketuohai Townships in Wushen County were chosen as iodine deficiency areas, and the survey was carried out from January to September 2013 . Random urine samples of school-age children ( 8 - 10 years old ) , pregnant women and lactating women were collected; urinary iodine was measured following the Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry(WS/T 107-2006) and iodine in edible iodized salt was measured following the General Test Method in Salt Industry Determination of Iodideion ( GB/T 13025 . 7-1999 ) . Results Fourteen of the provinces(autonomous regions and municipalities, including the Corps of Xinjiang) chose 25 mg/kg as their iodine concentration in edible iodized salt and 13 provinces chose 30 mg/kg. Besides, there were another 5 provinces providing 30 mg/kg particularly for pregnant women and lactating women while 25 mg/kg for other populations. In Tianjin, the medians of iodine concentration in edible iodized salt were ranged from 24.4 - 32.1 mg/kg in retail stores and 26.4 mg/kg at households. The household coverage rate of iodized salt and the proportion of households using adequately iodized salt were 78.5%(168/214) and 62.6%(134/214), respectively. The median ranges of urinary iodine were 178.2 - 183.9 μg/L in school children, 124.3 - 130.9 μg/L in pregnant women and 72.7 - 109.5 μg/L in lactating women. In Aksu, the medians of iodine concentration in edible iodized salt were 27.1 and 26.5 mg/kg in retail stores and households, respectively. The household coverage rate of iodized salt and the proportion of households using adequately iodized salt were 100.0% (363/363) and 98.9%(359/363), respectively. The median ranges of urinary iodine were 174.8 - 293.0, 154.9 - 230.0 and 135.8 - 239.3 μg/L among school children, pregnant women and lactating women, respectively. The median of iodine concentration in a special edible iodized salt sample reached 49.1 mg/kg, and qualified rate was 0(0/11) in Aksu. Conclusions All provinces , municipalities and autonomous regions ( including the Corps of Xingjiang ) in China have adjusted the iodine content in edible iodized salt in accordance with GB 26878-2011. However, in Tianjin the household iodine concentration in edible salt is lower than the local standards; the household coverage rate of iodized salt and the proportion of households using adequately iodized salt are lower than the national standards; pregnant women and lactating women are at risk of mild iodine deficiency.

Objective To explore the correlation between the change of the serum levels of thyroid hormone and the severity of anxiety symptoms in patients with generalized anxiety disorder after treatment with paroxetine hydrochloride.Methods 76 patients with generalized anxiety disorder treated in the Third People's Hospital of Huzhou from January to August 2023 were collected as study group,and they were divided into mild group(n=23),moderate group(n=30),and severe group(n=23),according to degree of anxiety by Hamilton anxiety scale(HAMA),69 healthy examination subjects in the same period were selected as control group.Patients in study group were treated with paroxetine hydrochloride tablets for 8 weeks,patients were evaluated anxiety symptoms,the serum levels of thyroid hormone were measured at baseline and 8 weekend,including triiodothyronine(T3),thyroxine(T4),free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),antithyroglobulin antibody(TG),anti-thyroid peroxidase antibody(TPO).Results After 8 weeks of paroxetine hydrochloride treatment,the significant efficacy rates of mild group,moderate group,and severe group were 73.9％,76.7％,and 73.9％,with no statistically significant difference in efficacy among three groups(x2=0.073,P＞0.05).In the baseline period,FT4 levels of patients in moderate group and severe group were significantly higher than those in mild group and control group,and the difference was statistically significant(P＜0.05).The severity of anxiety symptoms in the baseline period of patients in moderate group and severe group showed a low positive correlation and a significant positive correlation with FT4 levels(r=0.382、0.610,P＜0.05).After 8 weeks treatment,the FT4 levels of patients in moderate group and severe group decreased significantly compared to the baseline period,and the difference was statistically significant(t=2.847,3.042,P＜0.05).The reduction rate of HAMA score in severe group was positively correlated with the change in FT4 level during the baseline period and at the end of 8 weeks of treatment(r=0.517,P＜0.05).By a binary Logistic regression analysis showed that the higher levels of FT4 in the baseline period with the worse efficacy in moderate group and severe group.Conclusion The improvement of anxiety symptoms could be affected by high baseline levels of FT4 in generalized anxiety disorder patients with moderate to severe anxiety.

Objective:To explore the research hotspots of early enteral nutrition and analyze its development trend.Methods:The Web of Science core database was retrieved. HistCite and CiteSpace were used to conduct quantitative analysis and co-word clustering analysis of early enteral nutrition.Results:A total of 823 articles were retrieved, and the number of articles was increasing. The research hotspots of early enteral nutrition mainly included severe disease, esophageal cancer, acute pancreatitis, sepsis, malnourished patients and premature infants. At the same time, the selection of early enteral nutrition nutrients was also a research hotspot.Conclusions:Early enteral nutrition research in critically ill patients is mature, and other specialized fields can carry out specialized early enteral nutrition support based on the research on critically ill patients. In the future, comparative studies on the effects of different nutrients in early enteral nutrition can also be carried out.

To investigate the presence of integrated Epstein-Barr virus (EBV) DNA in the NK/T cell lymphoma (NKTCL) ge-nome and analyze the integration information in the genome of NKTCL cell lines. Methods: PCR and in situ hybridization were used to detect EBV infection in five EBV (+) NK/T samples and four EBV (-) NK/T samples provided by the biobanks of the First Affiliated Hospi-tal of Zhengzhou University. Whole-genome DNA of the samples was sequenced and subjected to bioinformatics analysis. Whole-ge-nome sequence alignment was used to identify the EBV integration sequence. BLAST analysis was used to compare EBV fasta files of the samples and EBV fasta library. CREST software was used to extract softclip reads, filter all paired reads, and enumerate their distri-bution on chromosomes. The integrated genomics viewer (IGV) was used to compare the distribution of reads in partial regions of chromosome. PCR was used to amplify the high-frequency integration region of the EBV DNA. The amplified fragments were sanger se-quenced. Results: EBV DNA and EBER expression were detected in five EBV (+) NK/T samples but not in the four EBV (-) NK/T samples. Sequencing depth, coverage depth, proportion of coverage, and proportion of alignment all met the requirements for subsequent re-search. Sequence alignment revealed that the captured sequences were viral sequences. Filtered reads were most numerous in EBV (+) NKTCL cell line SNK, YTS, and EBV (+) nasal NKTCL tissue. The reads were non-randomly enriched in chromosome 2. EBV DNA inte-gration in the 400 bp region of chr2:30234084-30234483 caused insertion or deletion in the chr2p23.1 site. Conclusions: EBV DNA is highly integrated in the chr2p23.1 site of EBV (+) NKTCL cells and may affect the expression of related genes.

Objective: To investigate the expression and clinical significance of programmed death-ligand 1 (PD-L1), programmed death-ligand 2 (PD-L2), and their receptor programmed cell death protein 1 (PD-1) in EBV-positive T/NK lymphoproliferative disease [Epstein-Barr virus-positive T/natural killer (NK)-cell lymphoproliferative disease, EBV(+)-T/NK-LPD]. Methods: The pathological paraffin-embedded tissues of 17 patients with EBV(+)-T/NK-LPD from the First Affiliated Hospital of Zhengzhou University from January 2013 to December 2017 were collected. These patients include 12 males and 5 females, aged 10-82 years old, the average age being 29 years, 4 people in gradeⅠ, 7 in gradeⅡ, 3 in gradeⅢ, and 3 people with hydroa vacciniforme-like lymphoproliferative disorders. Immunohistochemical SP method was used to detect the expression of PD-1, PD-L1, and PD-L2 in human EBV(+)-T/NK-LPD tissues. The relationship between PD-1, PD-L1, PD-L2 expression, and clinicopathological parameters, pathological grades and prognosis were analyzed by Fisher's exact probabilities and Spearman rank correlation. Result: After statistical analysis, the results showed that in 17 cases of tissue samples, there were 12 cases with positive PD-1 expression, 6 cases with positive PD-L1 expression and 5 cases with positive PD-L2 expression. There was no significant correlation between PD-1 and PD-L2 expression and prognosis (P>0.05). PD-L1 expression showed a positive correlation with prognosis (P<0.05). There was no significant correlation between the expression of PD-L1 and PD-L2 with age, sex, as well as LDH and Ki-67 levels (P>0.05). Moreover, there was no significant correlation of PD-1 and PD-L2 expression with pathological grade (r=0.141, r=-0.149, both P>0.05). However, there was a negative correlation between the PD-L1 expression and pathological grade (r=-0.563), and the correlation between the PD-L1 ex-pression and pathological grade was statistically significant (P<0.05). Conclusions: PD-1, PD-L1, and PD-L2 are abnormally expressed in the pathological tissues of EBV(+)-T/NK-LPD. Although there was no significant correlation between the expression of PD-1 and prognosis or pathological grade, it was significantly higher in EBV+T/NK-LPD. PD-1/PD-Ls associated signaling pathway is expected to be a potential new target for EBV(+)-T/NK-LPD immunotherapy.

Objective: To explore sex differences in 3D T1texture features in the progression of Alzheimer's disease (AD) and to predict the diagnosis of AD patients of different sex． Methods: Seventy-seven AD patients (34 males and 42 females) ，74 amnestic mild cognitive impairment ( aMCI) patients ( 35 males and 39 females) and 75 healthy controls (HC) (35 males and 40 females) were recruited and high-resolution 3-dimensional T1 structural images were collected． Brain regions closely related to AD brain damage were selected as regions of interest ( ROIs) ，texture feature extraction and feature screening were performed．Analyses were performed by sex，and the support vector machine (SVM) was used for classification and prediction. Results : In the AD vs HC，AD vs aMCI and aMCI VS HC groups by different sex，we obtained some brain regions with relatively high recognition index in different subgroups，and found that there were significant differences between female patients and male patients with high recognition index，and the recognition index of female patients ( area under the curve，accuracy，sensitivity and specificity were generally higher than that of male． Conclusion There are significant sex differences in texture features in AD process，and the classification and prediction ability of texture features in female patients is better， suggesting the importance of sex differences in AD research．This study provides some reliable biomarkers for early sex-specific identification of AD，which may be helpful for the early diagnosis and treatment of AD in the future.