Objective:To investigate the effect of circulating plasma cell(CPC)on the prognosis of multiple myeloma(MM),and to es-tablish and validate a modified CPC-RISS staging system based on CPC and RISS.Methods:A retrospective analysis was performed for the clinical data of 639 treatment-na?ve patients with MM who were treated in Department of Hematology,Xijing Hospital,from January 2006 to June 2023.Peripheral blood smear was used to calculate the percentage of CPC in patients,and the impact of CPC and other related factors on the prognosis of MM patients was analyzed.A CPC-RISS staging system was established based on RISS stage and the percentage of CPC,and the differences in survival and prognosis were analyzed between patients with different stages.Results:Compared with the patients without CPC,detectable CPC was significantly associated with various high-risk factors for MM,and the MM patients with CPC had a lower complete remission rate and shorter overall survival time and progression-free survival time.The modified CPC-RISS staging system was used to classify the patients with MM into four stages,and there were significant differences in median survival time and progression-free survival time between the patients with different stages of MM.Conclusion:The MM pa-tients with the presence of CPC exhibit more aggressive features,worse response to treatment,and a reduction in long-term survival rate.The modified CPC-RISS staging system can effectively predict the prognosis of treatment-na?ve MM patients.

Glucose-6-phosphate dehydrogenase(G6PD)deficiency is one of the most common monogenic genetic diseases in the world.China is the high incidence area of this disease.G6PD heterozygote is the main form of G6PD deficiency in females,which belongs to X-linked incomplete dominant inheritance.Therefore,the enzyme activities of female heterozygotes vary widely,showing normal to mild to moderate enzyme activi-ties.There is no unified calibrators for G6PD enzymatic detection reagents commonly used in clinical practice,and the results of the same sample detected by different kits from different manufacturers are different,so there is a phenomenon of missed detection in clinical screening of female G6PD heterozygotes.Although G6PD gene detection can effectively improve the detection rate of female heterozygotes,its clinical application is lim-ited due to cost and other reasons.Therefore,the development of detection methods that can improve the de-tection rate of female heterozygotes and are suitable for large-scale screening and clinical application will be an urgent need to be solved in clinical practice.This article reviews the epidemiology of G6PD deficiency,genetic characteristics of female G6PD gene,clinical manifestations and detection methods of G6PD female heterozy-gotes.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

ObjectiveThe purpose of this study was to investigate the effects of transcutaneous electrical acupoint stimulation (TEAS) on cognitive function of vascular dementia (VD) rats and its mechanism. MethodsVD rat model was established by modified two-vessel occlusion (2-VO). After modeling, TEAS and electroacupuncture (EA) were used to stimulate Baihui and Zusanli points of rats respectively for 14 d. After treatment, novel object recognition test, Morris water maze test, and Y maze test were used to evaluate the spatial memory and learning ability of rats. Hematoxylin and eosin staining was used to observe the morphology of hippocampal neurons. Transmission electron microscopy was used to observe the ultrastructure of hippocampal mitochondria. Enzyme-linked immunosorbent assay kits were used to detected the levels of SOD, CAT, GSH-Px, MDA and ROS in serum of rats. Western blot was used to detect the expression of PGC-1α, TFAM, HO-1, NQO1 proteins in the hippocampus, Keap1 protein in the cytoplasm and Nrf2, NRF1 proteins in the nucleus. ResultsAfter treatment for 14 d, compared to the model group, the escape latency of VD rats decreased, while the discrimination index, the times of rats crossing the original platform area, the residence time in the original platform quadrant, and the percentage of alternation increased. TEAS can improve the structure of hippocampal neurons and mitochondria of VD rats, showing that neurons were arranged more regularly and distributed more evenly, nuclear membrane and nucleoli were clearer, and mitochondrial swelling were reduced, mitochondrial matrix density were increased, and mitochondrial cristae were more obvious. The levels of SOD, GSH-Px and CAT in serum increased significantly, while the concentration of MDA and ROS decreased. TEAS also up-regulated the expression levels of PGC-1α TFAM, NQO1 and HO-1 proteins in the hippocampus and Nrf2, NRF1 proteins in the nucleus, but down-regulated the Keap1 protein in the cytoplasm. ConclusionTEAS can improve cognition, hippocampal neurons and mitochondrial structure of VD rats, and the effect is better than EA. The mechanism may be the activation of PGC-1α mediated mitochondrial biogenesis and antioxidant stress, which also provides a potential therapeutic technology and experimental basis for the treatment of VD.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Objective To investigate the expression level of circular RNA circ-TNRC6A in bladder cancer tissues and its mechanism of regulating the proliferation and migration of bladder cancer cells.Methods The expression level of circ-TNRC6A in bladder cancer tissues and its relationship with clinical stage of patients with bladder cancer were analyzed using the Cancer Genome Atlas database.The expression levels of circ-TNRC6A in human normal bladder epithelial cell SV-HUC-1 and bladder cancer cell lines(MGH-U3,5637,RT-4,T24,J82)were analyzed by real-time fluorescence quantitative PCR(qPCR).The circ-TNRC6A plas-mid(circ-TNRC6A group)and the control plasmid(NC group)were transfected into 5637 bladder cancer cells,respectively.The effects of circ-TNRC6A on the proliferation and migration of bladder cancer cells were detected by colony formation assay and cell scratch assay,respectively.The targeting relationship between circ-TNRC6A and microRNA(miR)-494-3p was predicted by bioinformatics technology and confirmed by lu-ciferase reporter gene assay.qPCR was used to detect the effect of circ-TNRC6A on miR-494-3p expression.Western blot was used to detect the effect of circ-TNRC6A on the expression of key proteins in Wnt/β-catenin signaling pathway.Results circ-TNRC6A was down-regulated in bladder cancer tissues compared with adja-cent tissues(P＜0.01).The expression level of circ-TNRC6A was correlated with the clinical stage of bladder cancer(P＜0.05).Compared with SV-HUC-1 cells,the expression of circ-TNRC6A was lower in bladder cancer cell lines(all P＜0.05),and the expression level of circ-TNRC6A was the lowest in 5637 cells(P＜0.01).Compared with the NC group,overexpression of circ-TNRC6A inhibited the proliferation of 5637 cells(P＜0.01)and reduced the migration ability of 5637 cells(P＜0.01).circ-TNRC6A could target miR-494-3p(P＜0.01).Compared with NC group,overexpression of circ-TNRC6A significantly reduced the expression level of miR-494-3p(P＜0.01)and inhibited the activation of Wnt/β-catenin signaling pathway(P＜0.01).Conclusion circ-TNRC6A inhibits the proliferation and migration of bladder cancer cells by down-regulating miR-494-3p.circ-TNRC6A may be a new therapeutic target for bladder cancer.

Objective To explore the medication rules in the patented Chinese medicine(CM)compound formulas for the prevention and treatment of respiratory infectious diseases,and to provide reference for the prevention and treatment of respiratory infectious diseases.Methods CM compound formulas for the prevention and treatment of respiratory infectious diseases were collected from the national patent database.After data screening and standardization,R language was used for data mining.Results A total of 429 patented CM compound formulas were included,involving 846 Chinese medicinals.There were 26 kinds of high-frequency Chinese medicinals,and the top 10 frequently-used drugs were Glycyrrhizae Radix et Rhizoma,Lonicerae Japonicae Flos,Scutellariae Radix,Forsythiae Fructus,Platycodonis Radix,Stemonae Radix,Armeniacae Semen Amarum,Astragali Radix,Bupleuri Radix,and Menthae Haplocalycis Herba.Most of the high-frequency Chinese medicinals were heat-clearing and toxin-removing drugs and qi-replenishing drugs.The medicinal properties of the patented CM compound formulas were usually cold,the medicinal flavors were usually bitter,sweet and pungent,and mostly had the meridian tropism of lung meridian.The association rule analysis yieled 19 core association rules and multiple drug combinations.Three drug clusters were obtained after cluster analysis.Conclusion For the prevention and treatment of respiratory infectious diseases,patented CM compound formulas are commonly formulated following the principles of compatibility of cold and warm drugs,compatibility of drugs for dispersing and descending,usually have the actions of dispersing pathogens in the lung,clearing heat and removing toxins,and also have the actions of replenishing qi and harmonizing the middle energizer,and nourishing yin and moistening dryness.The formulas have the efficiency of eliminating pathogens while not hurting the healthy qi,and strengthening the healthy qi while not maintaining pathogens.