Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Objective:To explore the clinical efficacy of modified Chaihu Jia Longgu Muli Decoction in patients with liver and kidney Yin deficiency syndrome of Parkinson's disease (PD) and the effects on phosphatase and tensin homolog-induced putative kinase 1 (PINK1) /E3 ubiquitin ligase (Parkin) signaling pathway.Methods:A randomized controlled trial study was conducted. A total of 120 PD patients from the Department of Encephalopathy of Xi'an Hospital of Traditional Chinese Medicine from May 2020 to May 2024 were selected as the observation objects and divided into 2 groups through random number table method, with 60 cases in each group. The control group took dopashydrazine tablets orally, while the combined group took Chaihu Jia Longgu Muli Decoction on the basis of the control group. Two groups were treated continuously for 2 months. The levels of glial cell-derived neurotrophic factor (GDNF), nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and basic fibroblast growth factor 2 (FGF2) were detected by ELISA. The expression levels of PINK1, Parkin and chelate 1 (SQSTM1) mRNA were detected by real-time fluorescence quantitative PCR. The adverse reactions during the treatment were observed and recorded to evaluate the clinical efficacy.Results:The total effective rate was 95.00% (57/60) in the combined group and 83.33% (50/60) in the control group, with statistical significance ( χ2=4.23, P=0.040). After treatment, the levels of serum GDNF [(510.78±31.57) ng/L vs. (431.89±30.45) ng/L, t=13.93], BDNF [(36.47±3.72) ng/L vs. (27.84±3.55) ng/L, t=13.00], NGF [(57.24±4.17) ng/L vs. (50.72±4.11) ng/L, t=8.63] and FGF2 [(26.21±3.71) ng/L vs. (21.63±3.54) ng/L, t=6.92] in the combined group were higher than those in the control group ( P<0.001). After treatment, the mRNA expression levels of PINK1 (2.38±0.07 vs. 2.19±0.05, t=17.11), Parkin (1.89±0.03 vs. 1.74±0.05, t=19.93), and SQSTM1 (1.82±0.07 vs. 1.61±0.05, t=18.91) in the combined group were higher than those in the control group ( P<0.001). During the treatment period, the incidence of adverse reactions was 6.67% (4/60) in the combined group and 10.00% (6/60) in the control group, without statistical significance ( χ2=0.44, P=0.509). Conclusion:Modified Chaihu Jia Longgu Muli Decoction can increase the levels of neurotrophic factors in patients with PD of liver and kidney yin deficiency syndrome, regulate the PINK1/Parkin pathway, protect neurons, improve mitochondrial autophagy function, and enhance clinical efficacy.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Objective:To explore the effect of complement component C1s on the proliferation,migration and adhesion of esophageal squamous cell carcinoma(ESCC)cells and on the growth of xenograft tumors in nude mice.Methods:The C1S mRNA ex-pression of ESCC tissues and adjacent normal tissues(ANTs)were analyzed using NCBI-GEO database.The C1s expression of ESCC cell lines was analyzed with RT-qPCR and Western blot.The knockdown or overexpression of C1s in ESCC cells lines was performed using C1s small interfering RNA(siRNA),C1s short hairpin RNA(shRNA)or C1s overexpression lentivirus,and the cell prolifera-tion was detected by CCK-8 assay,cell migration was detected by cell wound healing assay,cell adhesion was detected by cell-matrix adhesion assay,the expressions of matrix metalloproteinases MMP1 and MMP13 were detected by Western blot,and the effect of C1s on the growth of xenograft tumors in nude mice was detected by subcutaneous tumorigenesis assay in nude mice.The expression of CD34 in the xenograft tumors was detected by immunohistochemistry,and the formation of tumor microvessel was analyzed.Results:The expression of C1S mRNA in ESCC tissues was significantly higher than that in ANTs.Knockdown of C1s significantly suppressed proliferation,migration and cell-matrix adhesion of ESCC cells,as well as growth of xenograft tumors in nude mice,while overexpres-sion of C1s had the opposite effects.The expressions of MMP1 and MMP13 were decreased in ESCC cells TE-1 with C1s knockdown.Compared with control group,the microvessel of the xenograft tumors in the C1s overexpression group were more abundant.Conclu-sion:C1s is significantly upregulated in ESCC tissues,and promotes proliferation,migration,cell-matrix adhesion of ESCC cells,and the growth of xenograft tumors.C1s may play an important role in the occurrence and development of ESCC.

Objective To validate the performance of droplet digital polymerase chain reaction (ddPCR) reagents using clinical and standard strains, and to evaluate the effectiveness and practicability of ddPCR technology in clinical applications. Methods The concordance rate, specificity, precision, and lower limit of detection of the ddPCR kit were validated using clinical and standard strains. Blood samples from 74 patients with suspected bloodstream infections were collected, and both ddPCR and blood culture methods were used to determine the pathogens in the patient's blood samples. Results The average detection time of ddPCR for pathogens of bloodstream infection was 3.5 hours, which was able to complete the detection of over a dozen common pathogens simultaneously. The concordance rate, specificity, precision, and lower limit of detection of the ddPCR kit for bloodstream infection pathogens all met clinical requirements. Among the 74 patients with suspected bloodstream infections, the positive detection rate using the ddPCR method was 64.86%, while was 40.54% using blood culture, with a statistically significant difference (P < 0.05). Conclusion The method of ddPCR can detect common pathogens of bloodstream infections rapidly, efficiently, and in large quantities, and its main detection performance can meet clinical needs. The combination of blood culture and ddPCR technology is conductive to early and rapid diagnosis of clinical bloodstream infection patients.

Myocardial dysfunction is the most serious complication of sepsis. Sepsis-induced myocardial dysfunction (SMD) is often associated with gastrointestinal dysfunction, but its pathophysiological significance remains unclear. The present study found that patients with SMD had higher plasma gastrin concentrations than those without SMD. In mice, knockdown of the gastrin receptor, cholecystokinin B receptor (Cckbr), aggravated lipopolysaccharide (LPS)-induced cardiac dysfunction and increased inflammation in the heart, whereas the intravenous administration of gastrin ameliorated SMD and cardiac injury. Macrophage infiltration plays a significant role in SMD because depletion of macrophages by the intravenous injection of clodronate liposomes, 48 h prior to LPS administration, alleviated LPS-induced cardiac injury in Cckbr-deficient mice. The intravenous injection of bone marrow macrophages (BMMs) overexpressing Cckbr reduced LPS-induced myocardial dysfunction. Furthermore, gastrin treatment inhibited toll-like receptor 4 (TLR4) expression through the peroxisome proliferator-activated receptor α (PPAR-α) signaling pathway in BMMs. Thus, our findings provide insights into the mechanism of the protective role of gastrin/CCKBR in SMD, which could be used to develop new treatment modalities for SMD.

Objective To investigate the prevalence of hepatitis D virus (HDV) infection among patients with chronic hepatitis B virus (HBV) infection in some regions of China. Methods Serum samples were collected from 3 131 patients with chronic HBV infection in 10 provinces, cities, and autonomous regions of China from March 2021 to June 2022, and anti-HDV IgG ELISA was used for the detection of all serum samples. Nested reverse transcription-polymerase chain reaction (nRT-PCR) was used to detect HDV RNA in anti-HDV IgG-positive samples, and the nRT-PCR amplification products of HDV RNA-positive samples were sequenced and analyzed to determine HDV genotype. The clinical features of anti-HDV IgG-positive patients were analyzed. The Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results The positive rate of anti-HDV IgG in the 3 131 patients with chronic HBV infection was 0.70% (22/3 131), and that in the patients with chronic HBV infection in Inner Mongolia Autonomous Region, Xinjiang Uygur Autonomous Region, Beijing, and Hunan Province was 1.81% (16/886), 0.88% (2/226), 0.28% (2/708), and 1.00% (2/200), respectively; the patients with chronic HBV infection in Inner Mongolia Autonomous Region had a significantly higher positive rate of anti-HDV IgG than those in Beijing ( P =0.004), and there was no significant difference between the other regions ( P > 0.05). Clinical features of the patients with chronic HBV infection in Inner Mongolia Autonomous Region showed that compared with the anti-HDV IgG-negative group, the anti-HDV IgG-positive group had a significantly higher proportion of patients with Mongol nationality ( P =0.001), abnormal alanine aminotransferase ( P =0.007), or antiviral treatment ( P =0.029), as well as a significantly lower median HBV DNA level ( P =0.030). A total of 19 HDV RNA-positive samples were identified, all of which had HDV genotype 1. Conclusion The prevalence rate of HDV varies greatly across different regions of China, with a higher prevalence rate of HDV in patients with chronic HBV infection from Inner Mongolia Autonomous Region. HDV genotype 1 is the predominant genotype in some provinces and cities of northern China.

Objective:To retrieve, evaluate, and sum up the evidence on target temperature management in stroke patients, and summarize the best evidence.Methods:Based on the "6S" pyramid model, clinical practice guidelines, expert consensus, evidence summary, and systematic review on target temperature management in stroke patients were searched from top to bottom in British Medical Journal Best Practice, UpToDate, Joanna Briggs Institute Evidence-Based Health Care Center, Guidelines International Network, Agency for Healthcare Research and Quality, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, American Heart Association, American Stroke Association, European Stroke Organization, Medlive, Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang Data, VIP and China Biology Medicine Disc. The search period was from database establishment to October 7, 2022. Two researchers received evidence-based nursing training independently evaluated the quality of the article, extracted, integrated, and summarized the best evidence.Results:A total of 12 articles were included, including three clinical practice guidelines, four systematic reviews, and five expert consensuses. 24 best pieces of evidence were summarized from five aspects, involving target temperature population, target temperature implementation, complication monitoring, nutritional support, and prognosis evaluation.Conclusions:This study adopts an evidence-based approach to systematically summarize the best evidence for target temperature management in stroke patients, which can provide the best decision-making basis for clinical medical and nursing staff to manage temperature in stroke patients, further standardize temperature monitoring and management, and offer scientific basis for future research and practice.

Objective:To study the level of neutralizing antibodies produced in the population at different time intervals after completion of the inactivated 2019-nCoV vaccine immunization, and to evaluate the protective effect produced by the vaccine in the population.Methods:Fifty volunteers were included in this study, the neutralizing antibodies were detected by ELISA, and the inhibition rate and positive rate were calculated from the absorbance OD value.Results:The positive rates were 76% (38/50), 68% (34/50), 30% (15/50) and 100% (50/50) in the groups of 6, 8, 10 months’ intervals and intensive immunization, respectively; while the mean suppression rates were 58.80%, 49.86%, 34.60 and 95.55%, respectively. The result of the time main effects test showed that there was a statistically significant difference in the mean inhibition rate between the different time periods (F = 326.00, P<0.001). The paired t-test showed a gradual decrease in the mean inhibition rate in the 6th, 8th and 10th month, with a significant increase ( P<0.001) after 7-day in intensive immunization. Conclusions:This study showed after two doses of the 2019-nCoV vaccine, the level of neutralizing antibodies gradually decreased and weakened over time, but there was immune memory in the body, and when the body intensively stimulated by vaccine again, the level of neutralizing antibodies would rise significantly.

A 49-year-old male patient received transcutaneous transcatheter arterial chemoembolization and an IV infusion of camrelizumab 200 mg (on day 1 and 14 days was a cycle) due to liver cancer with intrahepatic metastasis, liver cirrhosis, splenomegaly, and ascites. On day 12 after the third IV infusion of camrelizumab, the patient developed fever, cough, and chest tightness. On day 34 after the third IV infusion of camrelizumab, chest CT showed ground glass exudation shadow in bilateral lungs. Immune-related pneumonitis and infection caused by camrelizumab was considered. High-dose methylprednisolone was given to inhibit immune reaction and cefoperazone sodium and sulbactam sodium was given to resist infection, supplemented with symptomatic and supportive treatments such as oxygen inhalation and expectorant. Eighteen days later, the patient′s body temperature returned to normal, chest tightness disappeared, but he coughed occasionally. Chest CT showed that the ground glass exudation shadow of bilateral lungs was narrowed on the scope.