Objective:To systematically review risk factors for prolonged postoperative ileus (PPOI) in colorectal surgery patients.Methods:Researches related to the influencing factors of PPOI in patients undergoing elective colorectal surgery were retrieved by computer in PubMed, Web of Science, Embase, Cochrane Library, Medline, China Biomedical Literature Database, China National Knowledge Infrastructure, WanFang Data and VIP. The retrieval time limit was from the establishment of the database to August 1, 2021. Two researchers screened article, extracted data, and evaluated the quality of the article. Meta-analysis was performed using RevMan 5.3 software.Results:A total of 21 articles were included. Meta-analysis results showed that the influence factors for PPOI in patients with colorectal surgery included gender [ OR=1.70, 95% confidence interval ( CI) : (1.55, 1.87) , P<0.001], smoking history [ OR=1.56, 95% CI: (1.30, 1.86) , P<0.001], chronic obstructive pulmonary disease [ OR=1.60, 95% CI: (1.52, 1.68) , P<0.001], hypertension [ OR=1.64, 95% CI: (1.03, 2.62) , P=0.04], diabetes [ OR=1.27, 95% CI: (1.09, 1.48) , P=0.002], history of abdominal surgery [ OR=2.15, 95% CI: (1.55, 2.98) , P<0.001], surgical site [ OR=1.40, 95% CI: (1.09, 1.81) , P=0.009], surgical method [ OR=0.43, 95% CI: (0.29, 0.62) , P<0.001], surgery time [ OR=1.18, 95% CI: (1.15, 1.22) , P<0.001] and intraoperative blood loss [ OR=1.77, 95% CI: (1.15, 2.71) , P=0.009]. Conclusions:The occurrence of PPOI in patients with colorectal surgery is affected by multiple factors. It is recommended that medical and nursing staff identify the risk factors of PPOI in a timely and accurate manner, and actively take measures to prevent the occurrence of PPOI and reduce the incidence of PPOI in patients.

Objective To explore the application of double-parameter three-dimension arterial spin labeling (3D-ASL) in evaluating collateral circulation in patients with unilateral chronic middle cerebral artery (MCA) occlusion.Methods From May 2015 to November 2017,24 patients with unilateral chronic MCA occlusion were scanned in Yantaishan Hospital by conventional MRI,DWI,3D-TOF-MRA and 3D-ASL (post-labeling delays:1.5 s and 2.5 s respectively) using a 3.0 T MR scanner.The cerebral blood flow (CBF) values were measured in region of interest in the occlusive cortical area and in the contralateral normal cerebral area.The differences in CBF value measured by 3D-ASL (PLD=1.5 s and PLD=2.5 s) were analyzed by statistical methods.Results All the patients (n=24) on 3D-ASL (PLD=1.5 s) presented with apparent hypoperfusion in the MCA occlusion territory;but 3D-ASL (PLD=2.5 s) demonstrated the basically same perfusion in bilateral MCA territories,without apparent hypoperfusion in one cerebral hemisphere.The subtraction images of 3D-ASL (PLD 2.5 s-PLD 1.5 s)presented laminated high signal areas in the cortical region of MCA occlusion.There was no statistically significant difference in CBF value of the contralateral normal cerebral area between measurements by 3D-ASL (PLD=1.5 s) and by 3D-ASL (PLD=2.5 s) (6.39±5.01 mL/100 g·min versus 55.87±6.89 mL/100 g· min) (P＞0.05).The CBF value of region of interest in the occluded cortical area (23.34±4.53 mL/100 g· min) was significantly lower than that in the contralateral normal cerebral area (55.87±6.89 mL/100 g·min) by 3D-ASL (PLD=1.5 s) (P＜0.05).The CBF value of region of interest in the occluded cortical area (53.93±8.59 mL/100 g·min) by 3D-ASL (PLD=2.5 s) was significantly higher than that by 3D-ASL (PLD=1.5 s) (23.34±4.53 mL/100 g·min) (P＜0.05).There was no statistically significant difference between the CBF value of region of interest in the occluded cortical area and that in the contralateral normal cerebral area by 3D-ASL (PLD=2.5 s) (P＞0.05).Conclusions 3D-ASL (PLD=1.5 s and PLD=2.5 s) can noninvasively and intuitively demonstrate the collateral circulation compensation in patients with chronic MCA occlusion.3D-ASL (PLD=1.5 s) can reflect the first-order collateral circulation compensation while 3D-ASL (PLD=2.5 s) can reflect accurately the secondary collateral circulation compensation.

Background::With an increasing number of patients with hematological malignancies being treated with umbilical cord blood transplantation (UCBT), the correlation between immune reconstitution (IR) after UCBT and graft-versus-host disease (GVHD) has been reported successively, but reports on double-negative T (DNT) cell reconstitution and its association with acute GVHD (aGVHD) after UCBT are lacking.Methods::A population-based observational study was conducted among 131 patients with hematological malignancies who underwent single-unit UCBT as their first transplant at the Department of Hematology, the First Affiliated Hospital of USTC, between August 2018 and June 2021. IR differences were compared between the patients with and without aGVHD.Results::The absolute number of DNT cells in the healthy Chinese population was 109 (70-157)/μL, accounting for 5.82 (3.98-8.19)% of lymphocytes. DNT cells showed delayed recovery and could not reach their normal levels even one year after transplantation. Importantly, the absolute number and percentage of DNT cells were significantly higher in UCBT patients without aGVHD than in those with aGVHD within one year ( F = 4.684, P = 0.039 and F = 5.583, P = 0.026, respectively). In addition, the number of DNT cells in the first month after transplantation decreased significantly with the degree of aGVHD increased, and faster DNT cell reconstitution in the first month after UCBT was an independent protective factor for aGVHD (HR = 0.46, 95% confidence interval [CI]: 0.23-0.93; P = 0.031). Conclusions::Compared to the number of DNT cells in Chinese healthy people, the reconstitution of DNT cells in adults with hematological malignancies after UCBT was slow. In addition, the faster reconstitution of DNT cells in the early stage after transplantation was associated with a lower incidence of aGVHD.

Objective:To evaluated the clinical efficacy of a reduced-intensity preconditioning regimen for single non-blood-related umbilical cord blood transplantation (sUCBT) in the treatment of severe aplastic anemia (SAA) .Methods:The clinical data of 63 patients with SAA who underwent sUCBT from January 2021 to July 2023 at the Department of Hematology of the First Affiliated Hospital of USTC were retrospectively analyzed. Fifty-two patients received total body irradiation/total bone marrow irradiation (TMI) combined with fludarabine or a cyclophosphamide- conditioning regimen (non-rATG group) , while 11 patients received rabbit anti-human thymocyte immunoglobulin (rATG) combined with TMI, fludarabine, or the cyclophosphamide-conditioning regimen (rATG group) . All patients received cyclosporine A and mycophenolate mofetil for graft-versus-host disease (GVHD) prophylaxis. Complications post-transplantation and long-term survival were compared between the two groups.Results:The baseline parameters were balanced between the two groups ( P>0.05) . In the rATG group, all patients achieved stem cell engraftment, and in the non-rATG group, five patients had primary graft failure. There was no significant difference in the cumulative incidence of neutrophil engraftment at 42 days after transplantation or platelet engraftment at 60 days between the two groups. The incidence of grade Ⅱ-Ⅳ acute GVHD in the rATG group was significantly lower than in the non-rATG group (10.0% vs. 46.2% , P=0.032) , and the differences in the cumulative incidences of grade Ⅲ/Ⅳ acute GVHD and 1-year chronic GVHD were not statistically significant ( P=0.367 and P=0.053, respectively) . There were no significant differences in the incidences of pre-engraftment syndrome, bacterial bloodstream infections, cytomegalovirus viremia, or hemorrhagic cystitis between the two groups ( P>0.05 for all) . The median follow-up time for surviving patients was 536 (61-993) days, and the 1-year transplantation related mortality (TRM) of all patients after transplantation was 13.0% (95% CI 6.7% -24.3% ) . Among the patients in the non-rATG and rATG groups, 15.5% (95% CI 8.1% -28.6% ) and 0% ( P=0.189) , respectively, had mutations. The 1-year overall survival (OS) rate of all patients after transplantation was 87.0% (95% CI 75.7% -93.3% ) . The 1-year OS rates in the rATG group and non-rATG group after transplantation were 100% and 84.5% , respectively (95% CI 71.4% -91.9% ) ( P=0.198) . Conclusion:The preliminary results of sUCBT with a low-dose irradiation-based reduced-intensity conditioning regimen with fludarabine/cyclophosphamide for the treatment of patients with SAA showed good efficacy. Early application of low-dose rATG can reduce the incidence of acute GVHD after transplantation without increasing the risk of implantation failure or infection.

Objective: To investigate the relationship between donor chimerism and relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: The clinical data of 105 patients with acute myeloid leukemia (AML) who underwent allo-HSCT and recurrence-free survival>90 days from January 2010 to January 2019 were retrospectively analyzed. The bone marrow samples were collected at 15, 30, 60, 90, 180, 270, 360 days after transplantation. Donor chimerism was detected by single nucleotide polymorphism (SNP) -PCR. Results: Of the 105 patients, 43 cases were male and 62 cases were female, with a median age of 38 (16-60) years. Till April 2019, the median follow-up was 843 (94-3 261) days. Ninety days after transplantation, 18 cases relapsed, 33 cases died, and 72 cases survived. The 3-year overall survival (OS) rate was (66.8±5.1) %, and the recurrence-free survival (RFS) rate was (65.1±5.0) %. Pre-transplant disease status, pre-transplant minimal residual disease (MRD) , and 90 day post-transplantation chimerism were independent risk factors related to RFS. The risk of recurrence was significantly increased in patients with a donor chimerism rate ≤97.24% at 90 days after transplantation[HR=6.921 (95%CI 2.669-17.950) , P<0.001], which was considered as a sign of early relapse. Conclusion SNP-PCR is an applicable method for detecting donor chimerism in patients after allo-HSCT. Chimerism rate equal or less than 97.24% at 90 days after transplantation predicts a higher risk of relapse.

Objective: To compare the difference of efficacy between traditional Hyper-CVAD/MA regimen and the adolescents inspired chemotherapy regimen, CH ALL-01, in treatment of adult Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph⁺ ALL) . Methods: In this study we retrospectively analyzed 158 Ph⁺ ALL patients receiving Hyper-CVAD/MA regimen (n=63) or CHALL-01 regimen (n=95) in our center and Changzheng hospital from January 2007 to December 2017, excluding patients with chronic myeloid leukemia in blast crisis. Tyrosine kinase inhibitor (TKI) was administered during induction and consolidation chemotherapy. Patients who underwent hematopoietic stem cell transplantation received TKI as maintenance therapy. Results: Of them, 91.1% (144/158) patients achieved complete remission (CR) after 1-2 courses of induction. CR rate was 90.5% (57/63) for patients in Hyper-CVAD/MA group and 91.6% (87/95) for patients in CHALL-01 group. There was no difference in CR rates between the two groups (χ²=0.057, P=0.811) . The last follow-up was June 2018. A cohort of 134 CR patients could be used for further analysis, among them, 53 patients received Hyper-CVAD/MA regimen and other 81 patients received CHALL-01 regimen. The molecular remission rates were significantly higher in CHALL-01 group (complete molecular response: 44.4%vs 22.6%; major molecular response: 9.9% vs 18.9%) (χ²=7.216, P=0.027) . For the patients in Hyper-CVAD/MA group, the 4-year overall survival (OS) was 44.81% (95%CI: 30.80%-57.86%) and the 4-year disease free survival (DFS) was 37.95% (95%CI: 24.87%-50.93%) . For patients received CHALL-01 regimen, the 4-year OS was 55.63% (95%CI: 39.07%-69.36%) (P=0.037) and 4 year DFS was 49.06% (95%CI: 34.24%-62.29%) (P=0.015) , while there was no significant difference in 4 year cumulative incidence of relapse (CIR) (P=0.328) or cumulative incidence of nonrelapse mortality (CI-NRM) (P=0.138) . The rate of pulmonary infection was lower in patients received CHALL-01 regimen compared with patients received Hyper-CVAD regimen (43.4% vs 67.9%, χ²=7.908, P=0.005) . Conclusions Outcome with CHALL-01 regimen appeared better than that with the Hyper-CVAD/MA regimen in Ph⁺ ALL, which has lower incidence of pulmonary infection, higher molecular remission rate and better OS and DFS.