Objective:To clarify the prognostic significance of 1q21 amplification in multiple myeloma(MM),and explore the efficacy and prognosis of ixazomib in the treatment of MM patients with 1q21 amplification.Methods:A retrospective analysis of clinical data was conducted on 77 patients with newly diagnosed MM who were hospitalized in Zhongshan Hospital,Xiamen University from January 2010 to December 2022.To analyze the clinical features of MM patients with 1q21 amplification,evaluate the mitigation rate and survival treated with ixazomib-based regimens.Results:Among the 77 newly diagnosed MM patients,40 patients had 1q21 amplification,while 37 didn't.Multivariate Cox regression analysis revealed that 1q21 amplification was an independent risk factor affecting the prognosis of MM patients(P＜0.05).Compared to patients without 1q21 amplification,those with 1q21 amplification had poorer progression-free survival(PFS)and overall survival(OS)(both P＜0.05).When the 1q21 amplification ratio exceeded 66.7％,both PFS and OS were worse(P＜0.05).There were no statistical differences in the deep remission rate(≥VGPR),overall response rate and PFS between the 1 q21 amplification positive and negative groups treated with ixazomib-based regimens(P＞0.05),but OS showed a significant difference(P＜0.05).Among the patients who switched to ixazomib treatment from bortezomib,there was a statistically significant difference in the complete response rate(P＜0.05).Compared to other treatment regimens,ixazomib-based regimens resulted in a significant reduction in adverse reactions such as peripheral neuropathy(P＜0.05).Conclusion:Ixazomib-based chemotherapy regimens can overcome the poor prognosis associated with 1q21 amplification and improve mitigation rates and PFS in patients.Ixazomib has low incidence of adverse reactions,good safety profile and prolonged duration of therapy.

Objective To investigate and compare the epidemiological characteristics of common respiratory viruses among influenza-like illness(ILI)and severe acute respiratory infection(SARI)cases in Huzhou,Zhejiang Province before and after the COVID-19 pandemic,so as to provide a basis for formulating and adjusting the prevention and control strategies for viral respiratory infectious diseases.Methods ILI and SARI cases at two influenza surveillance sentinel hospitals in Huzhou and had throat swab samples collected during Nov 2017 to Feb 2020(pre-COVID-19 pandemic period)and Dec 2022 to Apr 2024(post-COVID-19 mitigation phase)were selected as the participants.Seven common viral respiratory pathogens were tested,including influenza A virus(H1N1 and H3N2 subtypes),influenza B virus(Victoria lineage,FluB),respiratory syncytial virus(RSV),rhinovirus(HRV),adenovirus(ADV),and severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).The positive rates of respiratory pathogens before and after the COVID-19 pandemic were compared across different age groups and different time.Results A total of 7 948 ILI samples and 2 294 SARI samples were included.The overall positive rate of ILI samples increased from 33.6%to 47.1%,primarily due to the increase in influenza and COVID-19 infections;the overall positive rate of SARI samples decreased from 31.4%to 24.8%,mainly due to the reduction in HRV and ADV infections.During the post-COVID-19 mitigation phase,SARS-CoV-2(22.1%),H3N2(12.7%),and FluB(6.0%)were the primary pathogens in ILI samples,while RSV(7.1%),H3N2(5.3%),and HRV(4.5%)dominated in SARI samples.During the post-COVID-19 mitigation phase,the influenza virus circulation period was shortened.Before the COVID-19 pandemic,RSV was mainly detected in autumn and winter,while during the post-COVID-19 mitigation phase,out-of-season RSV epidemics were observed in spring and summer.Co-infection rate in ILI cases increased significantly in the post-COVID-19 mitigation phase,predominantly consisting of co-infections of COVID-19 and influenza A virus,while co-infection rate in SARI cases showed a decline.Conclusion We found important epidemiological changes in respiratory viruses in Huzhou during the post-COVID-19 mitigation phase compared to pre-COVID-19 period,including increased positive rates of influenza and COVID-19,and disruptions to the seasonal patterns of influenza and RSV.The prevention and control strategies should be adjusted in a timely manner based on the monitoring data.

Objective To analyze the association between lifestyle and the risk of type 2 diabetes(T2D)among adult residents.Methods The data was sourced from the Shanghai Suburban Adult Cohort and Biobank.A total of 42 096 adult residents who had not developed T2D were recruited from four districts of Shanghai(Songjiang,Jiading,Minhang,and Xuhui)between 2016 and 2019.The follow-up ended on Feb 28,2023.A structured questionnaire was used to collect information on six lifestyle-related items,including smoking,alcohol consumption,BMI,waist circumference(WC),physical activity,and diet.The unhealthy lifestyle scores(UHLS)were calculated by counting the number of all the unhealthy lifestyle items,with a range of 0-6.New-onset T2D events diagnosed by physicians were obtained through the medical information system.Cox proportional hazards regression model and restricted cubic spline model were utilized to evaluate the association between unhealthy lifestyles and the risk of T2D incidence.Results About 28.1%of the participants led 4-6 unhealthy lifestyles.A total of 1 752 new T2D cases were identified during 218 513.4 person-years of follow-up.Analysis of single unhealthy lifestyle showed that abnormal WC(HR=1.5,95%CI:1.4-1.7)and abnormal BMI(HR=1.3,95%CI:1.2-1.5)were associated with an increased risk of T2D.Compared with individuals with a UHLS of 0-1,those with a UHLS of 3 and 4-6 had 30%(95%CI:1.1-1.6)and 50%(95%CI:1.2-1.8)higher risks of T2D,respectively.Each additional unhealthy lifestyle was associated with a 10%increase in T2D incidence risk(HR=1.1,95%CI:1.1-1.2).Conclusion The risk of T2D in adult residents increases with the cumulative number of unhealthy lifestyles.Adult residents with abnormal WC or BMI,or have three or more unhealthy lifestyles accumulated,will increase the risk of new-onset T2D.

Objective:To investigate the factors influencing the delayed onset of intrapartum fever following epidural labor analgesia and their impact on maternal and neonatal outcomes.Methods:Select parturients who experienced intrapartum fever following labor analgesia(T≥38.0℃,age≥18 years,singleton pregnancy,ASA classification Ⅱ)between January 1,2021,and December 31,2023.Group them based on the median time of intra-partum fever onset after labor analgesia:those with onset times less than the median were classified as the ear-ly-onset fever group,and those with onset times greater than the median were classified as the late-onset fever group.Using univariate and multivariate Logistic regression analysis to explore factors influencing the delay in in-trapartum fever onset and the pregnancy outcomes of the mothers and newborns in both groups.Results:A total of 253 parturients were included,and the time range of onset of intrapartum fever following epidural labor analgesi-a was 1.83-28.42 hours,with a median fever onset time of 8.00 hours.There were 126 cases in the early-onset group and 127 in the late-onset group.Multivariate Logistic regression analysis indicated that primiparous women,artificial membrane rupture,and neonatal birth weight were independent risk factors for delayed fever onset(OR＞1,P＜0.05),whereas the administration of oxytocin prior to labor analgesia was found to be a protective factor(OR＜1,P＜0.05).The late-onset group exhibited higher levels of white blood cells(WBC),C-reactive pro-tein,longer hospital stays,higher hospitalization costs,greater diagnosis rates of chorioamnionitis,higher NICU ad-mission rates,as well as a higher incidence of neonatal pneumonia,for newborns compared to the early-onset group(P＜0.05).Conclusions:Primiparous women,artificial membrane rupture,and higher neonatal birth weight may be associated with delayed onset of intrapartum fever,while oxytocin administration prior to labor analgesia may offer some protective benefit.The later the onset of intrapartum fever,the worse the clinical outcomes for both mother and infants.

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.

The principe of electrical impedance tomography(EIT)was described,and the research progress of EIT technology in the field of gesture recognition was reviewed from the aspects of hardware system and gesture recognition algorithm.The challenges of EIT technology applied in the field of gesture recognition were analyzed,and the future development trends were envisioned.[Chinese Medical Equipment Journal,2025,46(4):93-99]

Objective To analyze the correlation of serum levels of GAT A-binding protein 3(GATA-3),T cell immunoglobulin domain and mucin domain protein-3(Tim-3)and retinoid-related orphan nuclear receptor gamma t(RORγt)with cardiac function and myocardial injury in-dicators in patients with coronary heart disease(CHD)and angina pectoris.Methods A retrospec-tive analysis was performed on 120 CHD patients with angina pectoris(observation group)in our hospital from December 2020 to December 2023.They were divided into stable angina subgroup(53 cases)and unstable angina subgroup(67 cases)according to the results of electrocardiography and coronary angiography.Another 120 healthy individuals taking physical examination in our hospital during the same period were subjected and served as the control group.ELISA was used to detect the serum levels of GATA-3,Tim-3 and RORγt.Left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and left ventricular short-axis shortening rate(FS)were measured by echocardio-graphy.Creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)were detected by biochemi-cal analyzer,and troponin Ⅰ(cTnⅠ)and heart fatty acid binding protein(H-FABP)were detected by electrochemiluminescence immunoassay.Pearson analysis was applied to analyze the correlation the correlation of serum levels of GATA-3,Tim-3 and RORγt with cardiac function and myocar-dial injury indicators.ROC curve was plotted to analyze the predictive value of the above three in-dicators for unstable angina.Results The serum levels of Tim-3 and ROR y t were significantly higher,and that of GATA-3 was obviously lower in the observation group than the control group(397.14±78.42 ng/L vs 246.45±56.81 ng/L,P＜0.01;93.18±19.94 ng/L vs 35.72±7.79 ng/L,P＜0.01;38.21±9.45 ng/L vs 71.62±14.98 ng/L,P＜0.01).The LVEDD and LVESD values were notably higher,while the LVEF and LVFS values were remarkably lower in the observation group than the control group(P＜0.01).The observation group has statistically higher cTnⅠ,CK,CK-MB,and H-FABP levels than the control group(P＜0.01).In the CHD patients with angina pectoris,serum GATA-3 level was positively correlated with LVEF and LVFS,and negatively with LVEDD,LVESD,cTnⅠ,CK,CK-MB,and H-FABP;Tim-3 and RORγt were negatively corre-lated with LVEF and LVFS,and positively with LVEDD,LVESD,cTnⅠ,CK,CK-MB,and H-FABP(P＜0.01).The AUC value of GATA-3,Tim-3,and RORγt alone and in combination in predicting unstable angina was 0.859,0.827,0.780,and 0.921,respectively,with that of combina-tion significantly higher than that of above indicators alone(Z=1.993,3.021,4.532,P=0.036,0.007,0.001).Conclusion As the disease progresses in CHD patients with angina pectoris,serum levels of Tim-3 and RORγt are increasing,while that of GATA-3 is decreasing,and all of them are closely associated with heart function and myocardial injury indicators.

Objective:To clarify the prognostic significance of 1q21 amplification in multiple myeloma(MM),and explore the efficacy and prognosis of ixazomib in the treatment of MM patients with 1q21 amplification.Methods:A retrospective analysis of clinical data was conducted on 77 patients with newly diagnosed MM who were hospitalized in Zhongshan Hospital,Xiamen University from January 2010 to December 2022.To analyze the clinical features of MM patients with 1q21 amplification,evaluate the mitigation rate and survival treated with ixazomib-based regimens.Results:Among the 77 newly diagnosed MM patients,40 patients had 1q21 amplification,while 37 didn't.Multivariate Cox regression analysis revealed that 1q21 amplification was an independent risk factor affecting the prognosis of MM patients(P＜0.05).Compared to patients without 1q21 amplification,those with 1q21 amplification had poorer progression-free survival(PFS)and overall survival(OS)(both P＜0.05).When the 1q21 amplification ratio exceeded 66.7％,both PFS and OS were worse(P＜0.05).There were no statistical differences in the deep remission rate(≥VGPR),overall response rate and PFS between the 1 q21 amplification positive and negative groups treated with ixazomib-based regimens(P＞0.05),but OS showed a significant difference(P＜0.05).Among the patients who switched to ixazomib treatment from bortezomib,there was a statistically significant difference in the complete response rate(P＜0.05).Compared to other treatment regimens,ixazomib-based regimens resulted in a significant reduction in adverse reactions such as peripheral neuropathy(P＜0.05).Conclusion:Ixazomib-based chemotherapy regimens can overcome the poor prognosis associated with 1q21 amplification and improve mitigation rates and PFS in patients.Ixazomib has low incidence of adverse reactions,good safety profile and prolonged duration of therapy.

Objective To investigate and compare the epidemiological characteristics of common respiratory viruses among influenza-like illness(ILI)and severe acute respiratory infection(SARI)cases in Huzhou,Zhejiang Province before and after the COVID-19 pandemic,so as to provide a basis for formulating and adjusting the prevention and control strategies for viral respiratory infectious diseases.Methods ILI and SARI cases at two influenza surveillance sentinel hospitals in Huzhou and had throat swab samples collected during Nov 2017 to Feb 2020(pre-COVID-19 pandemic period)and Dec 2022 to Apr 2024(post-COVID-19 mitigation phase)were selected as the participants.Seven common viral respiratory pathogens were tested,including influenza A virus(H1N1 and H3N2 subtypes),influenza B virus(Victoria lineage,FluB),respiratory syncytial virus(RSV),rhinovirus(HRV),adenovirus(ADV),and severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).The positive rates of respiratory pathogens before and after the COVID-19 pandemic were compared across different age groups and different time.Results A total of 7 948 ILI samples and 2 294 SARI samples were included.The overall positive rate of ILI samples increased from 33.6%to 47.1%,primarily due to the increase in influenza and COVID-19 infections;the overall positive rate of SARI samples decreased from 31.4%to 24.8%,mainly due to the reduction in HRV and ADV infections.During the post-COVID-19 mitigation phase,SARS-CoV-2(22.1%),H3N2(12.7%),and FluB(6.0%)were the primary pathogens in ILI samples,while RSV(7.1%),H3N2(5.3%),and HRV(4.5%)dominated in SARI samples.During the post-COVID-19 mitigation phase,the influenza virus circulation period was shortened.Before the COVID-19 pandemic,RSV was mainly detected in autumn and winter,while during the post-COVID-19 mitigation phase,out-of-season RSV epidemics were observed in spring and summer.Co-infection rate in ILI cases increased significantly in the post-COVID-19 mitigation phase,predominantly consisting of co-infections of COVID-19 and influenza A virus,while co-infection rate in SARI cases showed a decline.Conclusion We found important epidemiological changes in respiratory viruses in Huzhou during the post-COVID-19 mitigation phase compared to pre-COVID-19 period,including increased positive rates of influenza and COVID-19,and disruptions to the seasonal patterns of influenza and RSV.The prevention and control strategies should be adjusted in a timely manner based on the monitoring data.

Gastric cancer remains one of the most prevalent and lethal malignancies of the digestive tract worldwide,underscoring the urgent need for more effective targeted therapeutic strategies.Poly(ADP-ri-bose)polymerase(PARP)inhibitors have demonstrated remarkable efficacy in tumors with homologous recombination repair(HRR)deficiency;however,their clinical application in gastric cancer remains limited.Clinical evidence suggests that patients harboring Helicobacter pylori infection in combination with HRR gene mutations exhibit a significantly elevated risk of developing gastric cancer,thereby supporting the potential benefit of PARP inhibition in this setting.In this study,a kinase inhibitor library was screened in combination with the PARP inhibitor olaparib in gastric cancer cells.And we identify the cy-clin-dependent kinase 8/19(CDK8/19)inhibitor Senexin A as a compound that synergistically enhances the cytotoxic effect of PARP inhibition(P<0.05).Phenotypic validation using CCK-8 and colony for-mation assays demonstrated that the combination treatment significantly suppressed cellular proliferation and clonogenic potential compared to either monotherapy(P<0.0001).Mechanistically,alkaline comet assays revealed a significant increase in DNA damage in the combination treatment group relative to either single-agent group(P<0.0001),suggesting that the synergistic effect results from the exacerbation of DNA damage via impaired DNA repair mechanisms.In addition,treatment with CDK8/19 inhibitors a-lone markedly increased the formation of γH2AX and 53BP1 foci in irradiated gastric cancer cells(P<0.0001),indicating inhibition of DNA damage repair pathways.Transcriptome sequencing further re-vealed that CDK8/19 inhibition impacts critical cellular pathways,including DNA repair,cell cycle reg-ulation,and RNA splicing.Co-immunoprecipitation assays confirmed that inhibition of CDK8/19 kinase activity significantly reduces the phosphorylation level of PARP1,suggesting a potential regulatory inter-action.Immunohistochemical analysis of tumor and adjacent non-tumor tissues from gastric cancer pa-tients demonstrated that CDK8 is significantly overexpressed in tumor tissues,supporting its potential as both a prognostic biomarker and a therapeutic target.Collectively,this study elucidates a mechanistic ba-sis by which CDK8/19 inhibition enhances the sensitivity of gastric cancer cells to PARP inhibitors.These findings provide a strong rationale for the combined use of CDK8/19 and PARP inhibitors as a tar-geted therapeutic strategy and offer promising translational implications for advancing personalized medi-cine in gastric cancer treatment.