OBJECTIVES: To evaluate the safety and efficacy of thiotepa (TT)-containing conditioning regimens for allogeneic hematopoietic stem cell transplantation (HSCT) in children with inborn errors of immunity (IEI). METHODS: Clinical data of 22 children with IEI who underwent HSCT were retrospectively reviewed. Survival after HSCT was estimated using the Kaplan-Meier method. RESULTS: Nine patients received a traditional conditioning regimen (fludarabine + busulfan + cyclophosphamide/etoposide) and underwent peripheral blood stem cell transplantation (PBSCT). Thirteen patients received a TT-containing modified conditioning regimen (TT + fludarabine + busulfan + cyclophosphamide), including seven PBSCT and six umbilical cord blood transplantation (UCBT) cases. Successful engraftment with complete donor chimerism was achieved in all patients. Acute graft-versus-host disease occurred in 12 patients (one with grade III and the remaining with grade I-II). Chronic graft-versus-host disease occurred in one patient. The incidence of EB viremia in UCBT patients was lower than that in PBSCT patients (P<0.05). Over a median follow-up of 36.0 months, one death occurred. The 3-year overall survival (OS) rate was 100% for the modified regimen and 88.9% ± 10.5% for the traditional regimen (P=0.229). When comparing transplantation types, the 3-year OS rates were 100% for UCBT and 93.8% ± 6.1% for PBSCT (P>0.05), and the 3-year event-free survival rates were 100% and 87.1% ± 8.6%, respectively (P>0.05). CONCLUSIONS TT-containing conditioning for allogeneic HSCT in children with IEI is safe and effective. Both UCBT and PBSCT may achieve high success rates.
Humans ; Retrospective Studies ; Transplantation Conditioning/methods* ; Thiotepa/therapeutic use* ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Male ; Female ; Child, Preschool ; Infant ; Child ; Transplantation, Homologous ; Graft vs Host Disease ; Adolescent

OBJECTIVE: To investigate the clinical characteristics and prognosis of primary pulmonary lymphoma (PPL). METHODS: The clinical data of 17 patients with PPL admitted to Gansu Provincial Hospital from January 2013 to June 2023 were collected, and their clinical characteristics and prognosis were retrospectively analyzed and summarized. RESULTS: The median age of the 17 patients was 56 (29-73) years old. There were 8 males and 9 females. According to Ann Arbor staging system, there were 9 patients with stage I-II and 8 patients with stage III-IV. There were 14 patients with IPI score of 0-2 and 3 patients with IPI score of 3-4. All 17 patients had symptoms at the initial diagnosis, most of the first symptoms were cough, and 6 patients had B symptoms.Among the 17 patients, there were 8 cases of diffuse large B-cell lymphoma (DLBCL), 5 cases of mucosa-associated lymphoid tissue (MALT) lymphoma, 1 case of gray zone lymphoma (GZL), and 3 cases of Hodgkin's lymphoma (HL). 15 patients received chemotherapy, of which 3 cases received autologous hematopoietic stem cell transplantation(ASCT) and 3 cases received radiotherapy; 2 patients did not receive treatment. The median number of chemotherapy courses was 6(2-8). The short-term efficacy was evaluated, 12 patients achieved complete remission (CR) and 3 patients achieved partial remission (PR). The age, pathological subtype, sex, Ann Arbor stage, β₂-microglobulin(β₂-MG) level, lactate dehydrogenase(LDH) level were not correlated with CR rate (P >0.05), while IPI score was correlated with recent CR rate (P < 0.05 ). The median follow-up time was 31(2-102) months. One of the 12 CR patients died of COVID-19, and the rest survived. Among the 3 patients who did not reach CR, 1 died after disease progression, while the other 2 survived. One of the 2 untreated patients died one year after diagnosis. Both the median progression-free survival (PFS) time and overall survival (OS) time of the 17 patients were both 31 (2-102) months. CONCLUSION The incidence of PPL is low, and the disease has no specific clinical manifestations, which is easily missed and misdiagnosed. The pathological subtypes are mainly MALT lymphoma and DLBCL, and the treatment is mainly combined chemotherapy. The IPI score is related to the treatment efficacy.
Humans ; Middle Aged ; Male ; Female ; Adult ; Prognosis ; Aged ; Lung Neoplasms/therapy* ; Retrospective Studies ; Neoplasm Staging ; Lymphoma/therapy* ; Lymphoma, Large B-Cell, Diffuse

BACKGROUND: Hemorrhagic stroke (HS) is associated with significant disability and mortality. However, the relationship between meteorological factors and hemorrhagic stroke, as well as the potential moderating role of these factors, remains unclear. METHODS: Daily data on HS, air pollution, and meteorological conditions were collected from January 2015 to December 2021 in Ganzhou to analyze the relationship between meteorological factors and HS admissions. This analysis employed a time-stratified case-crossover design in conjunction with a distributional lag nonlinear model. Additionally, a bivariate response surface modelling was utilized to further investigate the interaction between meteorological factors and particulate matter. The study also stratified the analyses by gender and age. To investigate the potential impact of extreme weather conditions on HS, this study defined the 97.5th percentile as representing extremely high weather conditions, while the 2.5th percentile was classified as extremely low. RESULTS: In single-day lags, the risk of admissions for HS was significantly associated with extremely low temperature (lag 1-2 and lag 13-14), extremely low humidity (lag 1 and lag 9-12), and extremely high precipitation (lag 2-7). Females exhibited greater susceptibility to extremely low temperature than males within the single-day lag pattern in the subcomponent layer, with a maximum relative risk (RR) that was 7% higher. In the cumulative lag analysis, the risk of HS admissions was significantly associated with extremely high temperature (lag 0-8∼lag 0-14), extremely low humidity (lag 0-2∼lag 0-14), and extremely high precipitation (lag 0-4∼lag 0-14). Within the cumulative lag day structure of the subcomponent layer, both extremely low and extremely high temperature had a more pronounced effect on females and aged ≥65 years. The risk of HS admissions was positively associated with extremely high barometric pressure in the female subgroups (lag 0-1 and lag 0-2). The highest number of HS admissions occurred when high PM_2.5 concentrations coexisted with low precipitation. CONCLUSIONS Meteorological factors were significantly associated with the risk of hospital admissions for HS. Individuals who were female and aged ≥65 years were found to be more susceptible to these meteorological influences. Additionally, an interaction was observed between airborne particulate matter and meteorological factors. These findings contributed new evidence to the association between meteorological factors and HS.
China/epidemiology* ; Humans ; Female ; Male ; Aged ; Middle Aged ; Cross-Over Studies ; Hospitalization/statistics & numerical data* ; Adult ; Hemorrhagic Stroke/etiology* ; Meteorological Concepts ; Weather ; Particulate Matter/analysis* ; Air Pollution/adverse effects* ; Environmental Exposure/adverse effects* ; Aged, 80 and over ; Young Adult

Objective:To investigate the effects of short-peptide-based enteral nutrition on nutritional status, immune function, and chemotherapy-related adverse reactions in children with acute lymphoblastic leukemia (ALL).Methods:A total of 106 children with ALL receiving chemotherapy at the Affiliated Hospital of Jining Medical University between January 2021 and April 2022 were enrolled. According to the principle of between-group baseline data matching, the patients were divided into observation group and control group by random number table method, with 53 cases in each group. All patients received chemotherapy according to the CCCG-ALL-2020 protocol established by the Multi-center Cooperative Group of the Chinese Society of Pediatric Oncology (2020). The control group received a regular diet, while the observation group received a regular diet supplemented with short-peptide-based enteral nutrition. The incidence rates of malnutrition, hypoproteinemia, hypoalbuminemia, abnormal immunoglobulin levels (IgG, IgM, IgA), and adverse reactions (liver injury, infection) were compared between both groups before chemotherapy and at the end of each of the following seven chemotherapy phases: Induction remission therapy (PVDL), Induction remission therapy (CAT), Early intensification therapy (CAT+), Consolidation therapy (HDMTX), Interim maintenance therapy, Reinduction therapy, and prior to the end of Maintenance therapy. Normally or approximately normally distributed measurement data were expressed as xˉ± s and compared by independent samples t-test. Counting data were expressed as n (%) and compared by χ2 test. Results:During the CAT phase, the incidence of malnutrition was significantly lower in the observation group than in the control group [20.8% (11/53) vs. 39.6% (21/53), χ2=4.48, P=0.034]. The incidence of hypoproteinemia was significantly lower in the observation group during HDMTX, Reinduction, Interim maintenance, and prior to the end of Maintenance therapy [47.2% (25/53) vs. 69.8% (37/53), χ2=5.60, P=0.018; 45.3% (24/53) vs. 67.9% (36/53), χ2=5.53, P=0.019; 41.5% (24/53) vs. 64.2% (34/53), χ2=5.45, P=0.020; 28.3% (15/53) vs. 54.7% (29/53), χ2=7.62, P=0.006, respectively]. The incidence of hypoalbuminemia was significantly lower in the observation group during CAT+, HDMTX, Reinduction, Interim maintenance, and prior to the end of Maintenance therapy [5.7% (3/53) vs. 22.6% (12/53), χ2=6.29, P=0.012; 9.4% (5/53) vs. 26.4% (14/53), χ2=5.19, P=0.023; 9.4% (5/53) vs. 28.3% (15/53), χ2=6.16, P=0.013; 7.6% (4/53) vs. 24.5% (13/53), χ2=5.68, P=0.017; 3.8% (2/53) vs. 18.9% (10/53), χ2=6.01, P=0.014, respectively]. For IgG, incidence was significantly lower in the observation group during Interim maintenance, Reinduction, and prior to the end of Maintenance therapy [7.6% (4/53) vs. 22.6% (12/53), χ2=4.71, P=0.030; 20.8% (11/53) vs. 39.6% (21/53), χ2=4.48, P=0.034; 11.3% (6/53) vs. 26.4% (14/53), χ2=3.94, P=0.047, respectively]. For IgM, incidence was significantly lower in the observation group during the CAT and CAT+ phases [45.3% (24/53) vs. 66.0% (35/53), χ2=4.63, P=0.032; 58.5% (31/53) vs. 77.4% (41/53), χ2=4.33, P=0.037, respectively]. For IgA, incidence was significantly lower in the observation group during Reinduction therapy and Interim maintenance [22.6% (12/53) vs. 45.3% (24/53), χ2=6.06, P=0.014; 9.4% (5/53) vs. 24.5% (13/53), χ2=4.28, P=0.038, respectively]. For liver injury, incidence was significantly lower in the observation group during the CAT, CAT+, and prior to the end of Maintenance phases [22.6% (12/53) vs. 43.4% (23/53), χ2=5.16, P=0.023; 26.4% (14/53) vs. 50.9% (27/53), χ2=6.72, P=0.010, 11.3% (6/53) vs. 26.4%(14/53), χ2=3.94、 P=0.047,respectively]. For infection, incidence was significantly lower in the observation group during the CAT+ and HDMTX phases [35.9% (19/53) vs. 56.6% (30/53), χ2=4.59, P=0.032; 24.5% (13/53) vs. 43.4% (23/53), χ2=4.21, P=0.040, respectively]. Conclusions:Short-peptide-based enteral nutrition demonstrates significant advantages in the treatment of pediatric ALL. It provides substantial support for patient treatment and recovery by improving nutritional status, modulating immune function, and reducing chemotherapy-related adverse reactions.

Aim To investigate the protective effects of resveratrol(RSV)on hypoxia/reoxygenation(H/R)-induced apoptosis in H9c2 cardiomyocytes and the un-derlying mechanisms.Methods A model of H/R was established in H9c2 cardiomyocytes.Cell apoptosis was determined by flow cytometry.The expressions of Bax,Bcl-2,cleaved caspase-3 and JAK2/STAT3 signa-ling pathway proteins were detected by Western blot.The inhibitor of JAK2,AG490,was used to assess the effect of RSV on H/R-induced apoptosis in H9c2 car-diomyocytes after inhibiting JAK2/STAT3 signaling pathway.Results RSV could effectively inhibit H/R-provoked cell apoptosis in H9c2 cardiomyocytes and increase the expression of p-JAK2 and p-STAT3.After AG490 intervention,the anti-apoptotic effect of RSV on H9c2 cardiomyocytes caused by H/R was significantly counteracted.Conclusions RSV can inhibit H/R-in-duced apoptosis in H9c2 cardiomyocytes through the activation of JAK2/STAT3 signaling pathway.

Bone marrow suppression is one of the common adverse reactions to radiotherapy and chemotherapy. Anticancer treatments such as radiotherapy and chemotherapy first directly damage the patient′s peripheral blood cells, impairing qi and blood; further, they damage the actively proliferating cell populations in the bone marrow, impairing yin and blood; and then they interfere with hematopoietic stem cells, impairing essence and blood. This process is rapid and intense, consistent with the characteristics of " acute deficiency syndrome" , marked by sudden onset, rapid changes, critical condition, complexity and variability, multiple complications, and poor prognosis. Given this, its diagnosis and treatment should differ from those of general deficiency syndromes. This paper advocates the principles and ideas of diagnosis and treatment such as " preventing first and treating early to prevent changes; supplementing for deficiency and strengthening vital qi to eliminate pathogenic factor; urgent rescue for critical conditions, no time to lose; and comprehensive supplementing throughout the process, with severe cases requiring singular action" . This approach is intended to provide theoretical reference and practical guidance for bone marrow suppression after radiotherapy and chemotherapy.

Objective To explore the diagnostic value of deep learning image reconstruction(DLIR)com-bined with low-dose chest computed tomography(CT)with axial scan in the diagnosis of mycoplasma pneumoniae pneumonia(MPP)in children,and to provide reference for clinical practice.Methods 160 cases MPP children from February 2024 to June 2025 were selected as study subjects,and low-dose chest CT with axial scan was performed on all patients.DLIR and conventional adaptive iterative reconstruction-V(ASIR-V)were used for image reconstruction.The objective image quality[background noise(SD),signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR)],subjective image quality,and CT sign detection rate were compared,and the consistency of DLIR and ASIR-V in the diagnosis of MPP severity and clinical diagnosis was compared.Results As the intensity of DLIR and the weight of ASIR increasd,SD gradually decreased,while SNR and CNR gradually increased.The high-strength DLIR(DLIR-H)SD was lower than that of ASIR with a blending level of 80%(ASIR-V80%).The SNR and CNR were higher than those of ASIR-V80%,showing statistical significance(P<0.05).Ridit test showed that DLIR-H had the best subjective image quality score under different DLIR intensities,and ASIR-V80%had the best subjective image quality score under different ASIR weights.Furthermore,the subjective image quality score of DLIR-H was higher that of ASIR-V80%,and the differences were statistically significant(P<0.05).Using DLIR-H,the detection rates of air bronchogram,pulmonary consolidation,and interstitial infiltration(69.38%,86.88%,20.63%,respectively)were higher than those using ASIR-V80%(50.00%,71.88%,7.50%,respectively),and the differences were statistically significant(P<0.05).Consistency analysis showed that the Kappa value between the diagnostic results of MPP severity using DLIR-H and clinical diagnosis was 0.856(95%CI:0.771～0.996),while that between the diagnostic results of MPP severity using ASIR-V80%and clinical diagnosis was 0.498(95%CI:0.346～0.650).ROC analysis showed that the area under the curve(AUC)for diagnosing MPP severity was 0.925(95%CI:0.872～0.960)for DLIR-H and 0.729(95%CI:0.653～0.796)for ASIR-V80%,and the diagnostic value of DLIR-H was superior to that of ASIR-V80%(Z=3.952,P<0.001).Conclusion DLIR can effectively improve image quality.DLIR-H combined with low-dose chest CT with axial scan has high diagnostic value for the severity of MPP,and can serve as a feasible solution for clinical diagnosis of MPP severity and reducing radiation dose.

Objective:To investigate the effect of hypoxemia(HYP)on the expression of myeloid cell trigger receptor-1(TREM-1)in macrophage exosomes(Exo)and the effect of TREM-1 on the biological behavior of ovarian cancer cells.Methods:The expression of TREM-1 in 27 cases of epithelial ovarian cancer tissues and 30 cases of benign ovarian cysts were detected by immuno-histochemical staining.The human mononuclear cell line THP-1 was induced into macrophages by chemical induction method,and the siRNA silencing TREM-1 was transfected into the differentiated macrophages under HYP conditions.The macrophages Exo derived from normoxia(NOR)and HYP were isolated and co-cultured with the ovarian cancer cell line SKOV3.The cells were divided into the NOR-Exo group,HYP-Exo-siRNA group,HYP-Exo-siTREM-1 group and Control group.Transwell assay,scratch assay and Western blot were used to detect the invasion,migration,epithelial-mesenchymal transition(EMT)ability of ovarian cancer cells in each group,the expression of TREM-1 protein in cells,and the protein phosphorylation levels of P65,ERK1/2 and AKT in the NF-κB,ERK1/2 and AKT signaling pathways,respectively.Results:Compared with benign ovarian cyst,the expression of TREM-1 in ovarian cancer macrophage was significantly increased(P<0.05).Compared with NOR,HYP could significantly promote the expression of TREM-1 in macrophage and its Exo(P<0.05).Compared with Control group,the invasion,migration and EMT ability and the protein phosphorylation levels of P65,ERK1/2 and AKT in HYP-Exo-siRNA group and HYP-Exo-siTREM-1 group were significantly in-creased(P<0.05),there was no significant change in the NOR-Exo group(P>0.05).Compared with HYP-Exo-siRNA group,the above detection indexes in NOR-Exo group and HYP-Exo-siTREM-1 group were significantly decreased(P<0.05).Conclusion:HYP can up-regulate the EMT,invasion and migration ability of ovarian cancer cells by promoting the high expression of TREM-1 in Exo de-rived from macrophages,which may be related to the activation of NF-κB,ERK1/2 and AKT signaling pathways.

Objective:To investigate the effect of hypoxemia(HYP)on the expression of myeloid cell trigger receptor-1(TREM-1)in macrophage exosomes(Exo)and the effect of TREM-1 on the biological behavior of ovarian cancer cells.Methods:The expression of TREM-1 in 27 cases of epithelial ovarian cancer tissues and 30 cases of benign ovarian cysts were detected by immuno-histochemical staining.The human mononuclear cell line THP-1 was induced into macrophages by chemical induction method,and the siRNA silencing TREM-1 was transfected into the differentiated macrophages under HYP conditions.The macrophages Exo derived from normoxia(NOR)and HYP were isolated and co-cultured with the ovarian cancer cell line SKOV3.The cells were divided into the NOR-Exo group,HYP-Exo-siRNA group,HYP-Exo-siTREM-1 group and Control group.Transwell assay,scratch assay and Western blot were used to detect the invasion,migration,epithelial-mesenchymal transition(EMT)ability of ovarian cancer cells in each group,the expression of TREM-1 protein in cells,and the protein phosphorylation levels of P65,ERK1/2 and AKT in the NF-κB,ERK1/2 and AKT signaling pathways,respectively.Results:Compared with benign ovarian cyst,the expression of TREM-1 in ovarian cancer macrophage was significantly increased(P<0.05).Compared with NOR,HYP could significantly promote the expression of TREM-1 in macrophage and its Exo(P<0.05).Compared with Control group,the invasion,migration and EMT ability and the protein phosphorylation levels of P65,ERK1/2 and AKT in HYP-Exo-siRNA group and HYP-Exo-siTREM-1 group were significantly in-creased(P<0.05),there was no significant change in the NOR-Exo group(P>0.05).Compared with HYP-Exo-siRNA group,the above detection indexes in NOR-Exo group and HYP-Exo-siTREM-1 group were significantly decreased(P<0.05).Conclusion:HYP can up-regulate the EMT,invasion and migration ability of ovarian cancer cells by promoting the high expression of TREM-1 in Exo de-rived from macrophages,which may be related to the activation of NF-κB,ERK1/2 and AKT signaling pathways.

Objective To explore the diagnostic value of deep learning image reconstruction(DLIR)com-bined with low-dose chest computed tomography(CT)with axial scan in the diagnosis of mycoplasma pneumoniae pneumonia(MPP)in children,and to provide reference for clinical practice.Methods 160 cases MPP children from February 2024 to June 2025 were selected as study subjects,and low-dose chest CT with axial scan was performed on all patients.DLIR and conventional adaptive iterative reconstruction-V(ASIR-V)were used for image reconstruction.The objective image quality[background noise(SD),signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR)],subjective image quality,and CT sign detection rate were compared,and the consistency of DLIR and ASIR-V in the diagnosis of MPP severity and clinical diagnosis was compared.Results As the intensity of DLIR and the weight of ASIR increasd,SD gradually decreased,while SNR and CNR gradually increased.The high-strength DLIR(DLIR-H)SD was lower than that of ASIR with a blending level of 80%(ASIR-V80%).The SNR and CNR were higher than those of ASIR-V80%,showing statistical significance(P<0.05).Ridit test showed that DLIR-H had the best subjective image quality score under different DLIR intensities,and ASIR-V80%had the best subjective image quality score under different ASIR weights.Furthermore,the subjective image quality score of DLIR-H was higher that of ASIR-V80%,and the differences were statistically significant(P<0.05).Using DLIR-H,the detection rates of air bronchogram,pulmonary consolidation,and interstitial infiltration(69.38%,86.88%,20.63%,respectively)were higher than those using ASIR-V80%(50.00%,71.88%,7.50%,respectively),and the differences were statistically significant(P<0.05).Consistency analysis showed that the Kappa value between the diagnostic results of MPP severity using DLIR-H and clinical diagnosis was 0.856(95%CI:0.771～0.996),while that between the diagnostic results of MPP severity using ASIR-V80%and clinical diagnosis was 0.498(95%CI:0.346～0.650).ROC analysis showed that the area under the curve(AUC)for diagnosing MPP severity was 0.925(95%CI:0.872～0.960)for DLIR-H and 0.729(95%CI:0.653～0.796)for ASIR-V80%,and the diagnostic value of DLIR-H was superior to that of ASIR-V80%(Z=3.952,P<0.001).Conclusion DLIR can effectively improve image quality.DLIR-H combined with low-dose chest CT with axial scan has high diagnostic value for the severity of MPP,and can serve as a feasible solution for clinical diagnosis of MPP severity and reducing radiation dose.