Objective:To identify the risk factors for acute graft-versus-host disease (aGVHD) in patients with acute myeloid leukemia (AML) undergoing haploidentical hematopoietic stem cell transplantation (HID-HSCT) .Methods:A total of 141 AML patients who underwent HID-HSCT at the Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences, from January 2020 to July 2021 were included. The cumulative incidence of aGVHD was analyzed using the Fine-Gray competing risk model, with relapse and death as competing events, to compare differences between groups. Potential risk factors were evaluated by univariable and multivariable Cox proportional hazards regression analyses to determine their independent effects on aGVHD.Results:Among the 141 patients, 86 (61.0%) were male and 55 (39.0%) were female, with a median age at transplantation of 34 years. Within 100 days post-transplant, 59 patients developed grade Ⅱ-Ⅳ aGVHD, whereas 86 patients experienced no or grade Ⅰ aGVHD (the grade 0-Ⅰ aGVHD group) . Survival analysis showed that the 3-year overall survival was 68.7% (95% CI: 57.7%-81.9%) in the grade Ⅱ-Ⅳ aGVHD group, compared with 78.8% (95% CI: 70.4%-88.3%) in the grade 0 - Ⅰ aGVHD group, with the difference not being statistically significant ( P=0.190) . Univariable analysis identified donor age ( P=0.020, HR=1.020, 95% CI: 1.000-1.040) and the female donor-male recipient sex combination ( P=0.033, HR=1.980, 95% CI: 1.160-3.380) as risk factors for grade Ⅱ-Ⅳ aGVHD. Multivariable analysis confirmed that donor age ( P=0.005, HR=1.026, 95% CI: 1.008-1.047) and the female donor-male recipient sex combination ( P=0.002, HR=2.339, 95% CI: 1.354-4.037) were independent risk factors for aGVHD. Patients receiving grafts from donors aged >45 years had a significantly higher 100-day cumulative incidence of grade Ⅱ-Ⅳ aGVHD compared with those receiving grafts from donors ≤45 years [54.7% (95% CI: 42.3%-67.0%) vs 31.6% (95% CI: 21.0%-42.1%) , P=0.006]. Similarly, patients with the female donor-male recipient sex combination had a higher 100-day cumulative incidence of grade Ⅱ-Ⅳ aGVHD than those with other sex combinations [56.8% (95% CI: 40.4%-73.1%) vs 36.9% (95% CI: 27.5%-46.3%) , P=0.015]. Conclusion:Older donor age and the female donor-male recipient sex combination remain independent risk factors for aGVHD in patients with AML undergoing HID-HSCT.

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus

Abdominal aortic balloon occlusion is an emerging interventional treatment method,which has been used to control the risk of postpartum hemorrhage caused by pernicious placenta previa(PPP).Numerous studies have shown that abdominal aortic balloon occlusion can not only significantly reduce the difficulty and risk of surgery,shorten the time spent for surgery,but also further increase the success rate of surgery,which undoubtedly has a positive impact on both the delivery woman and neonate.This paper aims to make a brief introduction of the development history of abdominal aortic balloon occlusion and its technical principles,and to expound the timing of using abdominal aortic balloon occlusion and the clinical application of the balloon with different properties,focusing on the advantages of using abdominal aortic balloon in patients with PPP.It is expected that this paper can provide a reference for formulating clinical treatment strategies.

Objective To explore the application value of anhydrous ethanol as an alternative to methanol in the preparation of chromosomal specimens from peripheral blood lymphocytes, and to establish a set of quantitative analytical methods for objectively evaluating the effectiveness of specimen preparation. Methods Residual blood samples from routine laboratory slide preparation were used for lymphocyte culture. The standard slide preparation method was employed. The fixative in the control group was methanol and glacial acetic acid (3∶1). Four experimental groups were set up based on the ratio of anhydrous ethanol to glacial acetic acid in the fixative (volume ratios of 3∶1, 5∶1, 7∶1, and 9∶1 for experimental groups 1, 2, 3, and 4, respectively). A chromosomal analysis was conducted using an automated chromosome scanning/image analysis system to evaluate the morphology and dispersion of metaphase chromosomes in both control and experimental groups. Comparisons were made between the control and experimental groups regarding the dic + r aberration rate, ace aberration rate, chromosomal aberration rate, chromosome dispersion index, chromosome overlapping ratio, and dispersion index/overlapping ratio. Results Microscopic evaluation revealed that the preparation quality of experimental groups 1 and 2 was comparable to the control group. No statistically significant differences were observed in dic + r aberration rate between each of the experimental groups and the control (P > 0.05). All experimental groups except group 4 showed no significant differences in ace aberration rate and chromosome aberration rate compared with the control group (P > 0.05). Experimental groups 1 and 2 showed no significant differences in chromosome dispersion index, overlapping ratio, and dispersion index/overlapping ratio compared with the control group (P > 0.05). Conclusion A mixture of anhydrous ethanol and glacial acetic acid at a 5∶1 ratio is recommended for use as a fixative in the preparation of chromosomal specimens from peripheral blood lymphocytes. A quantitative index system for assessing the quality of chromosomal specimens was established, enabling objective evaluation of slide preparation effectiveness.

Objective:To construct an information management system based on the back-end framework of React componentization and front-end framework of Uni scalable enterprise,so as to explore its application effect in management for operation room.Methods:React was used as the backend framework to construct JavaScript program code library of user interface,and all front-end applications that adopted Uni as the development system of frontend framework were used to construct informatization management system based on React and Uni framework,so as to manage operation room of hospital.A total of 100 surgical equipment that were used in the operation room of Guizhou Provincial People's Hospital from January 2023 to December 2023 were selected.According to different management methods,the conventional management method was adopted to manage equipment during January and June 2023,while the management method of informatization management system(informatization management)based on React and Uni frameworks was adopted to manage these equipment during July and December 2023.The frequency of leaving operation room of nursing personnel due to non-nursing events,the timeliness rate of transporting surgical patients and incidence of adverse events of nursing,as well as implementation rates of"five confirmations"included confirmed equipment,confirmed staff,confirmed time,confirmed quality and confirmed quantity,between two kinds of management methods were compared.Results:In the 200 surgeries of adopting informatization management method,the frequency of leaving operation room of nursing personnel due to non-nursing events was 2.5%,which was lower than 7.5%of conventional management method,and the difference was statistically significant(x2=5.213,P<0.05).The implementation rate of the"five confirmations"for equipment was 100%,which was higher than that of conventional management methods,and the difference was statistically significant(x2=15.232,P<0.05).The timeliness rate of transporting surgical patients was 100%in 100 surgeries,which was higher than 85%of conventional management method,and the difference was significant(x2=15.136,P<0.05).The incidence of various kinds of adverse events of nursing in the operating room was 0 in 100 surgeries,which was lower than that of conventional management method,and the difference was statistically significant(x2=0.226,P<0.05).Conclusion:The informatization management system based on React and Uni framework can significantly reduce the frequency of leaving operation room of nursing personnel due to non-nursing events in operation room,and improve the work efficiency in operation room,and reduce the incidences of work errors and adverse events in management for surgery.

Objective To investigate the mechanism by which Yangmai Tongluo formula improves microcirculation disorders induced by high homocysteine(Hcy)levels via regulation of the acid sphingomyelinase(ASM)and endoplasmic reticulum(ER)stress pathways.Methods Fifty male C57BL/6J mice were divided randomly into a control group,Hcy model group,Yangmai Tongluo formula low-/high dose groups(5.3,10.4 g/kg,respectively),and a folic acid group(0.08 g/kg).Except for the control group,microcirculation disorders were induced in all mice using drinking water containing 1.8 g/L Hcy for 6 weeks.After modeling for 2 weeks,mice were administered the corresponding treatments by gavage for 4 weeks.Serum Hey concentrations and the blood perfusion volume of the lower extremity microvessels were measured.Protein expression levels of zonula occludens ZO-1,ZO-2,intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),ASM,glucose-regulated protein 78(GRP78),and C/EBP homologous protein(CHOP)in the cardiac microvascular endothelium were analyzed using immunofluorescence.Results Serum Hcy levels were significantly increased in the Hcy model group compared with the control group(P＜0.05).Yangmai Tongluo formula did not significantly reduce Hey levels compared with the Hey model group,but blood perfusion in the lower extremities was significantly increased(P＜0.01)and expression levels of ZO-1 and ZO-2 in the cardiac microvascular endothelium were restored(P＜0.001)in the Yangmai Tongluo formula high dose group.It also inhibited the expression of ICAM-1,VCAM-1,ASM,GRP78,and CHOP(P＜0.05),with comparable effects to folic acid.Conclusions Yangmai Tongluo formula improves Hcy-induced microcirculation disorders and endothelial dysfunction by inhibiting ASM activity and alleviating ER stress,via a mechanism closely related to the regulation of endothelial inflammation and barrier stability.These result provide experimental evidence to support the use of traditional Chinese medicine to treat microvascular diseases.

Objective To investigate the mechanism by which Yangmai Tongluo formula improves microcirculation disorders induced by high homocysteine(Hcy)levels via regulation of the acid sphingomyelinase(ASM)and endoplasmic reticulum(ER)stress pathways.Methods Fifty male C57BL/6J mice were divided randomly into a control group,Hcy model group,Yangmai Tongluo formula low-/high dose groups(5.3,10.4 g/kg,respectively),and a folic acid group(0.08 g/kg).Except for the control group,microcirculation disorders were induced in all mice using drinking water containing 1.8 g/L Hcy for 6 weeks.After modeling for 2 weeks,mice were administered the corresponding treatments by gavage for 4 weeks.Serum Hey concentrations and the blood perfusion volume of the lower extremity microvessels were measured.Protein expression levels of zonula occludens ZO-1,ZO-2,intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),ASM,glucose-regulated protein 78(GRP78),and C/EBP homologous protein(CHOP)in the cardiac microvascular endothelium were analyzed using immunofluorescence.Results Serum Hcy levels were significantly increased in the Hcy model group compared with the control group(P＜0.05).Yangmai Tongluo formula did not significantly reduce Hey levels compared with the Hey model group,but blood perfusion in the lower extremities was significantly increased(P＜0.01)and expression levels of ZO-1 and ZO-2 in the cardiac microvascular endothelium were restored(P＜0.001)in the Yangmai Tongluo formula high dose group.It also inhibited the expression of ICAM-1,VCAM-1,ASM,GRP78,and CHOP(P＜0.05),with comparable effects to folic acid.Conclusions Yangmai Tongluo formula improves Hcy-induced microcirculation disorders and endothelial dysfunction by inhibiting ASM activity and alleviating ER stress,via a mechanism closely related to the regulation of endothelial inflammation and barrier stability.These result provide experimental evidence to support the use of traditional Chinese medicine to treat microvascular diseases.

Objective:To construct an information management system based on the back-end framework of React componentization and front-end framework of Uni scalable enterprise,so as to explore its application effect in management for operation room.Methods:React was used as the backend framework to construct JavaScript program code library of user interface,and all front-end applications that adopted Uni as the development system of frontend framework were used to construct informatization management system based on React and Uni framework,so as to manage operation room of hospital.A total of 100 surgical equipment that were used in the operation room of Guizhou Provincial People's Hospital from January 2023 to December 2023 were selected.According to different management methods,the conventional management method was adopted to manage equipment during January and June 2023,while the management method of informatization management system(informatization management)based on React and Uni frameworks was adopted to manage these equipment during July and December 2023.The frequency of leaving operation room of nursing personnel due to non-nursing events,the timeliness rate of transporting surgical patients and incidence of adverse events of nursing,as well as implementation rates of"five confirmations"included confirmed equipment,confirmed staff,confirmed time,confirmed quality and confirmed quantity,between two kinds of management methods were compared.Results:In the 200 surgeries of adopting informatization management method,the frequency of leaving operation room of nursing personnel due to non-nursing events was 2.5%,which was lower than 7.5%of conventional management method,and the difference was statistically significant(x2=5.213,P<0.05).The implementation rate of the"five confirmations"for equipment was 100%,which was higher than that of conventional management methods,and the difference was statistically significant(x2=15.232,P<0.05).The timeliness rate of transporting surgical patients was 100%in 100 surgeries,which was higher than 85%of conventional management method,and the difference was significant(x2=15.136,P<0.05).The incidence of various kinds of adverse events of nursing in the operating room was 0 in 100 surgeries,which was lower than that of conventional management method,and the difference was statistically significant(x2=0.226,P<0.05).Conclusion:The informatization management system based on React and Uni framework can significantly reduce the frequency of leaving operation room of nursing personnel due to non-nursing events in operation room,and improve the work efficiency in operation room,and reduce the incidences of work errors and adverse events in management for surgery.

Objective:To identify the risk factors for acute graft-versus-host disease (aGVHD) in patients with acute myeloid leukemia (AML) undergoing haploidentical hematopoietic stem cell transplantation (HID-HSCT) .Methods:A total of 141 AML patients who underwent HID-HSCT at the Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences, from January 2020 to July 2021 were included. The cumulative incidence of aGVHD was analyzed using the Fine-Gray competing risk model, with relapse and death as competing events, to compare differences between groups. Potential risk factors were evaluated by univariable and multivariable Cox proportional hazards regression analyses to determine their independent effects on aGVHD.Results:Among the 141 patients, 86 (61.0%) were male and 55 (39.0%) were female, with a median age at transplantation of 34 years. Within 100 days post-transplant, 59 patients developed grade Ⅱ-Ⅳ aGVHD, whereas 86 patients experienced no or grade Ⅰ aGVHD (the grade 0-Ⅰ aGVHD group) . Survival analysis showed that the 3-year overall survival was 68.7% (95% CI: 57.7%-81.9%) in the grade Ⅱ-Ⅳ aGVHD group, compared with 78.8% (95% CI: 70.4%-88.3%) in the grade 0 - Ⅰ aGVHD group, with the difference not being statistically significant ( P=0.190) . Univariable analysis identified donor age ( P=0.020, HR=1.020, 95% CI: 1.000-1.040) and the female donor-male recipient sex combination ( P=0.033, HR=1.980, 95% CI: 1.160-3.380) as risk factors for grade Ⅱ-Ⅳ aGVHD. Multivariable analysis confirmed that donor age ( P=0.005, HR=1.026, 95% CI: 1.008-1.047) and the female donor-male recipient sex combination ( P=0.002, HR=2.339, 95% CI: 1.354-4.037) were independent risk factors for aGVHD. Patients receiving grafts from donors aged >45 years had a significantly higher 100-day cumulative incidence of grade Ⅱ-Ⅳ aGVHD compared with those receiving grafts from donors ≤45 years [54.7% (95% CI: 42.3%-67.0%) vs 31.6% (95% CI: 21.0%-42.1%) , P=0.006]. Similarly, patients with the female donor-male recipient sex combination had a higher 100-day cumulative incidence of grade Ⅱ-Ⅳ aGVHD than those with other sex combinations [56.8% (95% CI: 40.4%-73.1%) vs 36.9% (95% CI: 27.5%-46.3%) , P=0.015]. Conclusion:Older donor age and the female donor-male recipient sex combination remain independent risk factors for aGVHD in patients with AML undergoing HID-HSCT.

Objective:To investigate the therapeutic effect and safety of recombinant human thrombopoietin (rhTPO) combined with low-dose eltrombopag in the treatment of persistent thrombocytopenia after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:A retrospective case series study was conducted. The retrospective analysis was conducted on the clinical data of 20 patients diagnosed with post-allo-HSCT thrombocytopenia at Blood Diseases Hospital of Chinese Academy of Medical Sciences from January 2018 to June 2021. All patients didn't meet the platelet implantation criteria [without the platelet count (Plt) ≥20×10 9/L for a consecutive period of 7 days and discontinuation of platelet transfusion] after transplantation, and they received subcutaneous injections of rhTPO (15 000 U) once daily and oral administration of eltrombopag (50 mg) once. Treatment efficacy was defined as maintaining Plt≥20×10 9/L for a consecutive period of 7 days after treatment and discontinuation of platelet transfusion; treatment inefficacy was defined as Plt<20×10 9/L after treatment or continuation of platelet transfusion. The therapeutic effect of rhTPO combined with low-dose eltrombopag was analyzed; the adverse reactions were evaluated; the clinical characteristics were compared between the effective treatment group and ineffective treatment group; the overall survival (OS) and disease-free survival (DFS) were analyzed using Kaplan-Meier method between the effective treatment group and ineffective treatment group. Results:Among the 20 patients, 9 were diagnosed with acute myeloid leukemia (AML), 5 with acute lymphoblastic leukemia (ALL), 4 with myelodysplastic syndromes (MDS), and 2 with severe aplastic anemia (SAA); 10 cases were primary failure of platelet recovery (PFPR), and 10 cases were secondary failure of platelet recovery (SFPR). The median time [ M ( Q1, Q3)] from transplantation to initiation of treatment was 79 days (50 days, 89 days), and the median duration of treatment was 19.5 days (15 days, 30 days). Of the total cohort, treatment was effective in 13 cases (65.0%, 8 cases of PFPR, 5 cases of SFPR), while 7 patients (35.0%) showed no response to treatment. The median time to achieve the therapeutic response among responders was 10 days (7 days, 19 days). During the combination treatment, 5 patients experienced elevated transaminase levels exceeding more than 2.5 times the upper limit of normal or bilirubin levels surpassing twice that limit. No instances of adverse reaction-related arterial thrombosis, myelofibrosis, or primary disease relapse occurred within this patient cohort. Megakaryocyte counts in the effective treatment group before combination treatment were higher than that in the ineffective treatment group, and the difference was statistically significant [14 (10, 20) vs. 2.5 (2, 4); Z = -2.33, P = 0.017]; Notably, no statistically significant differences were identified when comparing the compositions of gender, type of underlying diseases, human leukocyte antigen matching degree, blood type of donor and recipient, conditioning regimen use of antithymocyte globulin, quantity of CD34 + cells transfused, type of thrombocytopenia, acute graft-versus-host disease, fungal or bacterial infections, and viral infections between the two groups (all P > 0.05). The 1-year OS rates for the effective and ineffective treatment groups were 100.0% and 42.9%, respectively, and the difference in OS between the two groups was statistically significant ( P = 0.001). The 1-year DFS rates for the effective and ineffective treatment groups were 92.3% and 28.6%, respectively, and the difference in DFS between the two groups was statistically significant ( P = 0.003). Conclusions:The combination of rhTPO and low-dose eltrombopag has demonstrated certain therapeutic efficacy and good safety in the treatment of persistent thrombocytopenia after allo-HSCT.