Objective:To compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective: Patients with advanced gastric cancer have a poor prognosis and a possibility of peritoneal metastasis even if receiving gastrectomy. Hyperthermic intraperitoneal chemotherapy (HIPEC) can effectively kill free cancer cells or small lesions in the abdominal cavity. At present, preventive HIPEC still lacks safety evaluation in patients with locally advanced gastric cancer. This study aims to explore the safety of radical resection combined with HIPEC in patients with locally advanced gastric cancer. Methods: A descriptive case series study was carried out. Clinicopathological data of 130 patients with locally advanced gastric cancer who underwent radical resection + HIPEC at the Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2020 to February 2021 were retrospectively analyzed. Inclusion criteria: (1) locally advanced gastric adenocarcinoma confirmed by postoperative pathology; (2) no distant metastasis was found before surgery; (3) radical resection; (4) at least one HIPEC treatment was performed. Exclusion criteria: (1) incomplete clinicopathological data; (2) tumor metastasis was found during operation; (3) concomitant with other tumors. HIPEC method: all the patients received the first HIPEC immediately after D2 radical resection, and returned to the ward after waking up from anesthesia; the second and the third HIPEC were carried out according to the patient's postoperative recovery and tolerance; interval between two HIPEC treatments was 48 h. Observation indicators: (1) basic information, including gender, age, body mass index, etc.; (2) treatment status; (3) perioperative adverse events: based on the standard of common adverse events published by the US Department of Health and Public Health (CTCAE 5.0), the adverse events of grade 2 and above during the treatment period were recorded, including hypoalbuminemia, bone marrow cell reduction, wound complications, abdominal infection, lung infection, gastroparesis, anemia, postoperative bleeding, anastomotic leakage, intestinal obstruction, pleural effusion, abdominal distension, impaired liver function, and finally a senior professional title chief physician reviewed the above adverse events and made a safety evaluation of the patient; (4) association between times of HIPEC treatment and adverse events in perioperative period; (5) analysis of risk factors for adverse events in perioperative period. Results: Among the 130 patients, 79 were males and 51 were females with a median age of 59 (54, 66) years and an average body mass index of (23.9±7.4) kg/m(2). The tumor size was (5.4±3.0) cm and 100 patients (76.9%) had nerve invasion. All the 130 patients received radical resection + HIPEC and 125 (96.2%) patients underwent laparoscopic surgery. The mean operative time was (345.6±52.3) min and intraoperative blood loss was (82.0±36.5) ml. One HIPEC treatment was performed in 54 patients (41.5%), 2 HIPEC treatments were in 57 (43.8%), and 3 HIPEC treatments were in 19 (14.6%). The average postoperative hospital stay was (13.1±7.5) d. A total of 57 patients (43.8%) had 71 cases of postoperative complications of different degrees. Among them, the incidence of hypoalbuminemia was 22.3% (29/130), and the grade 2 and above anemia was 15.4% (20/130), lung infection was 3.8% (5/130), bone marrow cell suppression was 3.7% (4/130), abdominal cavity infection was 2.3% (3/130), and liver damage was 2.3% (3/130), wound complications was 1.5% (2/130), abdominal distension was 1.5% (2/130), anastomotic leakage was 0.8% (1/130), gastroparesis was 0.8% (1/130) and intestinal obstruction was 0.8% (1/130), etc. These adverse events were all improved by conservative treatments. There were no statistically significant differences in the incidence of adverse events during the perioperative period among patients undergoing 1, 2, and 3 times of HIPEC treatments (all P>0.05). Univariate and multivariate logistic analyses showed that age > 60 years (OR: 2.346, 95%CI: 1.069-5.150, P=0.034) and neurological invasion (OR: 2.992, 95%CI: 1.050-8.523, P=0.040) were independent risk factors for adverse events in locally advanced gastric cancer patients undergoing radical resection+HIPEC (both P<0.05). Conclusions: Radical surgery + HIPEC does not significantly increase the incidence of perioperative complications in patients with advanced gastric cancer. The age >60 years and nerve invasion are independent risk factors for adverse events in these patients.
Female ; Gastrectomy ; Humans ; Hyperthermic Intraperitoneal Chemotherapy ; Male ; Middle Aged ; Peritoneal Neoplasms/therapy* ; Retrospective Studies ; Stomach Neoplasms/surgery*

The progressive destruction of condylar cartilage is a hallmark of the temporomandibular joint (TMJ) osteoarthritis (OA); however, its mechanism is incompletely understood. Here, we show that Kindlin-2, a key focal adhesion protein, is strongly detected in cells of mandibular condylar cartilage in mice. We find that genetic ablation of Kindlin-2 in aggrecan-expressing condylar chondrocytes induces multiple spontaneous osteoarthritic lesions, including progressive cartilage loss and deformation, surface fissures, and ectopic cartilage and bone formation in TMJ. Kindlin-2 loss significantly downregulates the expression of aggrecan, Col2a1 and Proteoglycan 4 (Prg4), all anabolic extracellular matrix proteins, and promotes catabolic metabolism in TMJ cartilage by inducing expression of Runx2 and Mmp13 in condylar chondrocytes. Kindlin-2 loss decreases TMJ chondrocyte proliferation in condylar cartilages. Furthermore, Kindlin-2 loss promotes the release of cytochrome c as well as caspase 3 activation, and accelerates chondrocyte apoptosis in vitro and TMJ. Collectively, these findings reveal a crucial role of Kindlin-2 in condylar chondrocytes to maintain TMJ homeostasis.
Aggrecans/metabolism* ; Animals ; Cartilage, Articular/metabolism* ; Chondrocytes/pathology* ; Cytoskeletal Proteins/metabolism* ; Mice ; Muscle Proteins/metabolism* ; Osteoarthritis/pathology* ; Temporomandibular Joint/pathology*

OBJECTIVE: To investigate the therapeutic effect of spleen low molecular weight extracts on epileptics hydrochloride-induced leukopenia in mice and explore its mechanism. METHODS: The model of leukopenia in mice was established by the injection of epirubicin hydrochloride (10 mg/kg). After the injection of chemotherapeutic drugs, leukocytopenia mice were treated with different doses of spleen low molecular weight extract, Ganoderma oral solution and recombinant granulocyte colony stimulating factor (rhG-CSF). The general survival status indicators such as body weight, coat color and athletic ability of mice in each group were recorded; the tail vein blood of mice in each group was collected and the white blood cell count in them was calculated; bone marrow of mice was taken and bone marrow smears were observed. RESULTS: In the model group, the weight of the mice gradually decreased in the later period, their coat became dark and rough, and the ability to exercise decreased, while the mice in the treatment groups showed different degrees of improvement in their survival status except for the mice treated by rhG-CSF. There was no significant fluctuation in the white blood cell count of the blank control mice. After injection of epirubicin, the white blood cell count of peripheral blood in the model mice and treated mice were decreased. The white blood cell count was lower in the mice treated with high-dose low molecular weight extract and rhG-CSF than that in other experimental groups. Bone marrow smear showed that the proportion of bone marrow nucleated cells in the mice treated with the low molecular weight extract of the spleen was significantly higher than that of model mice (P<0.05). CONCLUSION The low molecular weight spleen extracts can significantly improve the hematopoietic state of mouse bone marrow, promote the proliferation of inhibited bone marrow cells, and thus has the effect of treating leukopenia in mice.
Animals ; Epirubicin ; Granulocyte Colony-Stimulating Factor ; Leukocyte Count ; Leukopenia/drug therapy* ; Mice ; Molecular Weight ; Plant Extracts ; Recombinant Proteins ; Spleen

Objective:To investigate the effect of middle-column preserved pedicle subtraction closing-opening wedge osteotomy for the treatment of old thoracolumbar compression fractures combined with kyphosis deformity.Methods:A retrospective case series study was performed to analyze data of 27 patients with old thoracolumbar compression fractures combined with kyphosis deformity admitted in Taizhou Hospital from January 2010 to January 2017. There were 10 males and 17 females, with age range of 45-75 years (mean, 61.7 years). The injured segments and osteotomy segments included T 11 in 5 patients, T 12 in 10, L 1in 8 and L 2 in 4. Time from initial fracture to surgery was 9-120 months (mean, 23.2 months). According to the American Spinal Injury Association (ASIA) classification, neurological impairment symptoms were detected in 9 patients, including grade C in 1 and grade D in 8. All patients underwent one-level middle-column preserved pedicle subtraction osteotomy. Operation time, blood loss, and perioperative complications were recorded. Before operation, at 3 months after operation and at latest follow-up, kyphosis Cobb angle, sagittal vertical axis (SVA) and height of anterior column (AC) as well as posterior column (PC) were measured. Visual analogue scale (VAS) and Oswestry disability index (ODI) score were used to evaluate the clinical efficacy. American Spinal Injury Association (ASIA) score was used to assess neurological function. Results:All patients were followed up for average 18.1 months (range, 12-34 months). Operation time was (155.2±35.4)minutes (range, 130-250 minutes). Blood loss was (338.1±101.4)ml (range, 150-550 ml). No serious neurological or vascular complications occurred during perioperative period. Kyphosis Cobb angle was (6.0±3.1)° at postoperative 3 months compared to preoperative (46.5±8.5)°( P<0.05), and showed no significant loss at latest follow-up [(7.9±3.8)°] ( P>0.05). SVA was improved significantly from preoperative [42.7(25.5, 78.2)]mm to [5.5(1.2, 7.3)]mm at postoperative 3 months ( P<0.05). AC height was increased by average 16.3 mm at postoperative 3 months compared to the preoperative level ( P<0.05), with no significant change in PC height ( P>0.05). There was no significant difference in SVA, AC height and PC height at postoperative 3 months and latest follow-up ( P>0.05). There were significant differences in VAS [(1.7±0.8)points, (2.3±1.4)points] and ODI (17.3±7.5, 19.4±4.3) at postoperative 3 months and at latest follow-up compared to these before operation [(7.7±1.3)points, 61.4±6.2] ( P<0.05), with no significant differences in VAS and ODI at postoperative 3 months and latest follow-up ( P>0.05). No implant failure was noted during follow-up. The osteotomy surface was fused in all patients at postoperative 6 months. At latest follow-up, ASIA grade was improved from grade C to grade D in 1 patient and from grade D to grade E in 8 patients. Conclusion:Middle-column preserved pedicle subtraction closing-opening wedge osteotomy can effectively correct old thoracolumbar fractures with kyphosis, relieve pain and improve nerve function.

Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Cyclophosphamide ; Doxorubicin ; Etoposide ; Feasibility Studies ; Granulocyte Colony-Stimulating Factor ; Humans ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; Polyethylene Glycols ; Prednisone ; Recombinant Proteins ; Rituximab ; Vincristine

OBJECTIVE: To explore the composition of microbial communities in vagina and intestine of the mother,the placenta and the neonatal meconium after cesarean section and to analyze the origin of neonatal intestinal microbiota.METHODS: Samples of intestine,vagina and placenta and neonatal meconium from 4 women who underwent cesarean section in Yan'an Hospital of Kunming City in October 2016 were collected.The high-throughput sequencing technology was used to sequence the 16 S rRNA gene,and the composition of the microbial communities and the relationship among the samples were analyzed.RESULTS: Firstly,comparing the number of OTUs in different samples,it was found that the number in placenta was the highest,followed by the intestine and vagina,and the least was in the neonatal meconium.Secondly,each sample was analyzed by PCA clustering,and it was found that the neonatal meconium was affected least by individual differences but the vagina was affected most.The intestinal and placental microbial communities had certain similarities.Finally,comparing the microbial community composition of each sample,it was found that the highest abundance in the neonatal meconium and placenta was Proteobacteria,and in the intestine and vagina it was the Firmicutes.CONCLUSION: During the caesarean section,maternal microbiota transfer may be from the mother's intestine to the placenta and then to the infant's intestine.

Objective The study aims to investigate the prevalence of gestational diabetes mellitus (GDM) among pregnant women in Tongzhou district of Beijing and its related risk factors. Methods Information of 34 637 singleton pregnancies delivered in a maternal and child health care hospital in Tongzhou district of Beijing were collected from January 1, 2013 to December 31, 2017. GDM prevalence of pregnant women were calculated. Multivariable logistic regression analysis was used to analyze the association between GDM and its related factors. Results The prevalence of GDM in 34 637 singleton pregnant women in Tongzhou district of Beijing was 23.2% (8 034/34 637). Multivariate analysis showed that advanced maternal age(aOR=1.87, 95% CI: 1.71-2.05), high level of education(aOR=1.19-1.23), delivering during 2016-2017(aOR=1.46, 95% CI: 1.38-1.55), macrosomia(aOR=1.27, 95% CI: 1.02-1.59), history of cesarean section(aOR=1.18, 95% CI: 1.08-1.30), history of spontaneous abortion(aOR=1.23, 95% CI:1.10-1.37), history of induced abortion(aOR=1.08, 95% CI:1.01-1.14), family history of diabetes(aOR=1.51, 95% CI:1.26-1.83), multipara(aOR=1.24, 95% CI:1.15-1.34), pre-pregnancy overweight(aOR=2.02, 95% CI:1.89-2.15), pre-pregnancy obesity(aOR=3.11, 95% CI:2.81-3.43)and conceived by assisted reproductive technology(aOR=1.47, 95% CI:1.03-2.10)were the independent risk factors for GDM. Conclusions Prevalence of GDM is high in pregnant women in Tongzhou district of Beijing. Health education before and during pregnancy should be carried out to monitor and prevent the occurrence of GDM in time to ensure maternal and child health.