To study the role of BK virus(BK polyomavirus)in the development of the hemorrhagic cystitis(HC)after hematopoietic stem cell transplantation(HSCT)and analyze the risk fators for BK viruri4a and HC.Methods From August 2006 to November 2007,blood and urine samples were collected from 80 patients undergoing HSCT.BK virus DNA was detected with PCR.Cytomegalovirus (CMV)antigen was detected with immunofluorescence histochemical examination.A control group including 20 healthy individuals was established.Results Late-onset HC occurred in 15 of the 80 HSCT patients with an incidence of 18.8%.The median onset time of HC was 44(13-150)days after transplantation.BK viruria was detected in 30 of the 80 HSCT patients(37.5%)and the positive rate of viruria in the HC patients was 86.7%(13/15).The median time of BK viruria detection in HC patients wag 23(0-56)days after transplantation,being earlier than the onset time of HC.The persistence time of BK viruria was 7(2-14) weeks,being much longer than that of HC(11 days).CMV antigen viremia was detected in 12 of the 80 transplanted patients.with a positive rate of 36.7% in patients with BK viruria and 40.0% in HC patients.Nine of the 30 HC patients developed acute graft versus host disease(Agvhd)of grade Ⅱ-Ⅳ(30.0%).BK virus was not detected in the urine of the remainimg two HC patients and the 20 control subjects as well as in all the blood samples.Univariate analysis indicated that CMV viremia and Agvhd of grade Ⅱ-Ⅳ were agsociated with the occurrence of BK viruria.Condusions BK viruria is the main cauge of the late-onset HC after HSCT.CMV infection and Agvhd may contribute to the occurrence of HC agsociatieg with BK virus.

Objective To analyze the routine test parameter levels of patients with colorectal adenoma and colorectal cancer, and develop a prediction model. Methods A total of 580 patients diagnosed with colorectal adenoma (117 patients) and colorectal cancer (463 patients) were included in the retrospective study. The patients were randomly divided into two groups according to a 7:3 ratio: a training set with 406 cases and a validation set with 174 cases. Logistic regression analysis was used to establish a prediction model, and a nomogram was drawn. The model′s discrimination, calibration, and clinical applicability were evaluated using receiver operating characteristic curve (ROC), calibration plot, and decision curve analysis (DCA). Results Univariate logistic regression analysis identified 13 potential predictors: age, fecal occult blood test (FOBT), fibrinogen (FIB), thrombin time (TT), albumin (ALB), white blood cell value (WBC), neutrophil count (NEUT#), hematocrit value (HCT), mean corpuscular hemoglobin (MCH), red cell distribution width (RDW), platelet count (PLT), mean platelet volume (MPV), and activated partial thromboplastin time (APTT). Multivariate logistic regression analysis showed MPV, FIB, ALB, FOBT, TT, and HCT were risk factors for colorectal cancer in patients with colorectal adenoma (P<0.05). A nomogram was constructed based on these predictors to build a prediction model. The AUC of the ROC curve was 0.915 for colorectal cancer in the training set and 0.836 in the validation set. Calibration plots demonstrated high prediction accuracy and good model calibration. DCA results indicated the prediction model provided greater net benefit compared with the extreme models at threshold probabilities of approximately 55%-95%. Conclusion The developed prediction model exhibits satisfactory discrimination, calibration, and clinical applicability. The model can serve as an auxiliary tool in distinguishing between colorectal adenoma and colorectal cancer in patients.