OBJECTIVE: To investigate the clinical characteristics, treatment and prognosis of adult AML patients with NUP98::HOXA9 fusion gene. METHODS: From May 2017 to October 2023， among 2 113 AML patients who visited the Hematology Department of our hospital, patients with NUP98 rearrangements were screened. The clinical characteristics, chromosome karyotypes, immunophenotypes, gene mutations, treatment efficacy and prognosis of the patients with NUP98::HOXA9 positive were analyzed. RESULTS: Among the 2 113 AML patients, there were 18 cases with NUP98 rearrangement, including 14 NUP98::HOXA9 positive cases, with a detection rate of 0.66% (14/2 113). The median age of the NUP98::HOXA9 positive patients was 42.5 (23-64) years old. The most common chromosome karyotype was t(7; 11)(p15; p15). The immunophenotypes of all patients expressed CD13, CD33, CD117 and CD38, and most patients expressed CD34 and cMPO, while only a few expressed HLA-DR. Second-generation sequencing (NGS) was performed to detect genetic mutations associated with leukemia in all 14 patients, and the genes exhibiting a high frequency of mutation were WT1 (10/14), TET2 (7/14), and FLT3-ITD (6/14). Additionally, mutations were also observed in KRAS/NRAS, IDH1, and KIT. Of the 13 patients who received treatment, 9 achieved complete remission (CR), and all 3 patients who received azacytidine(AZA)+ venetoclax (VEN) regimen achieved CR after the first course of treatment. Within this cohort, 6 patients were classified as relapsed/refractory (6/13). 4 patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT), of which two achieved long-term survival. The median follow-up time was 12 (2.1-65.0) months, while the median overall survival (OS) and relapse-free survival (RFS) were recorded as 11.4 months and 9.6 months, respectively. CONCLUSION The most common type of NUP98 rearrangement in adults AML patients is NUP98::HOXA9 , which is often accompanied by somatic mutations in WT1, TET2, and FLT3-ITD. These patients are prone to relapse, have short survival time, and generally face poor prognoses. Hopefully, utilization of the AZA+VEN regimen is anticipated to enhance the rate of induced remission in the patients, and some patients may prolong their survival through allo-HSCT. However, more effective treatment methods are still needed to improve the overall prognosis of these patients.
Humans ; Adult ; Leukemia, Myeloid, Acute/genetics* ; Middle Aged ; Prognosis ; Nuclear Pore Complex Proteins/genetics* ; Oncogene Proteins, Fusion/genetics* ; Mutation ; Male ; Female ; Young Adult ; Homeodomain Proteins/genetics*

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome

Objective To evaluate the medical resource consumption due to healthcare-associated infection(HAI)in patients with tumor based on disease diagnosis-related grouping(DRG).Methods Medical records of discharged patients from a tumor center of a hospital in 2022 were analyzed retrospectively,and differences in indicators such as average length of hospital stay and average expenses per hospitalization between the HAI group and the non-HAI group were compared.Results A total of 10 674 cases were included in the analysis,and 217 cases(2.03％)were in the HAI group.The average expense per hospitalization(5.10[2.38,8.43]10 000 Yuan vs 1.16[0.74,2.04]10 000 Yuan)and average length of hospital stay(25[13,40]days vs 6[4,11]days)of patients in the HAI group were both higher than those in the non-HAI group,both with statistically significant differences(both P＜0.05).The most common infection was bloodstream infection and pulmonary infection,accounting for 23.96％and 22.58％,respectively.In the three DRG groups,namely,RC19(radiotherapy for malignant proliferative disea-ses),RU12(supportive treatment for malignant proliferative diseases[length of hospital stay 7-29 days]),and RB19(high-dose chemotherapy and/or other treatments for acute leukemia),patients in the HAI group had higher average expenses per hospitalization and average length of hospital stay than patients in the non-HAI group,diffe-rences were all statistically significant(all P＜0.05).Conclusion DRG assessment can effectively identify key po-pulations for HAI prevention and control,contribute to implement precise infection prevention and control strate-gies,and reduce HAI incidence and related medical resource consumption.

Objective:To explore the epidemiological characteristics, imaging findings, pulmonary function changes, dust exposure situations, and treatment outcomes of accelerated silicosis through an analysis of existing literature.Methods:In December 2024, relevant literature from January 1, 1965 to December 15, 2024 was retrieved through the China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, EMbase, and PubMed databases. Keywords included "rapidly progressive silicosis" "accelerated silicosis" "subacute silicosis""artificial stone" and related terms. By incorporating, analyzing, and retrieving data from literatures, a comprehensive review of the epidemiology, clinical features, treatment options, and prognosis of fast forward silicosis was conducted.Results:A total of 72 literatures were included, including 23 cohort studies, 28 case reports, 3 case-control studies, and 18 cross-sectional studies. The average age of all 1794 patients was 33.67 years, with an average dust exposure duration of 5.58 years. The primary occupations associated with accelerated silicosis were stone processing, mining, and artificial quartz stone manufacturing. Imaging findings predominantly included small nodules, ground-glass opacities, and massive fibrosis. Antifibrotic treatment at the early stage of the disease could clearly delay disease progression. However, dust concentrations in workplaces were significantly above safety limits, with inadequate protective measures.Conclusion:Accelerated silicosis is characterized by its rapid onset, swift progression, and unfavorable prognosis. However, it has not garnered adequate attention in the present context. Reliable standard and guidelines are urgently needed to guide clinical diagnosis and treatment.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective To evaluate the medical resource consumption due to healthcare-associated infection(HAI)in patients with tumor based on disease diagnosis-related grouping(DRG).Methods Medical records of discharged patients from a tumor center of a hospital in 2022 were analyzed retrospectively,and differences in indicators such as average length of hospital stay and average expenses per hospitalization between the HAI group and the non-HAI group were compared.Results A total of 10 674 cases were included in the analysis,and 217 cases(2.03％)were in the HAI group.The average expense per hospitalization(5.10[2.38,8.43]10 000 Yuan vs 1.16[0.74,2.04]10 000 Yuan)and average length of hospital stay(25[13,40]days vs 6[4,11]days)of patients in the HAI group were both higher than those in the non-HAI group,both with statistically significant differences(both P＜0.05).The most common infection was bloodstream infection and pulmonary infection,accounting for 23.96％and 22.58％,respectively.In the three DRG groups,namely,RC19(radiotherapy for malignant proliferative disea-ses),RU12(supportive treatment for malignant proliferative diseases[length of hospital stay 7-29 days]),and RB19(high-dose chemotherapy and/or other treatments for acute leukemia),patients in the HAI group had higher average expenses per hospitalization and average length of hospital stay than patients in the non-HAI group,diffe-rences were all statistically significant(all P＜0.05).Conclusion DRG assessment can effectively identify key po-pulations for HAI prevention and control,contribute to implement precise infection prevention and control strate-gies,and reduce HAI incidence and related medical resource consumption.

Objective:To evaluate the efficacy and safety of nebulized inhalation of recombinant human interferon (IFN) α1b injection in the treatment of respiratory syncytial virus (RSV) associated lower respiratory tract infections (pneumonia and bronchiolitis) in children.Methods:A randomized, double-blind, parallel, placebo-controlled add-on design was used.Children with pneumonia or bronchiolitis aged 2 months to 5 years who tested positive for RSV antigen within 72 hours of onset from 30 clinical trial sites including Beijing Children′s Hospital, Capital Medical University between February 2021 and December 2022 were included in this study and randomly divided into 2 groups at a ratio of 1∶1 based on a stratified-block method.Both groups received basic treatments such as cough control, asthma relieving, expectorant treatment, fever reduction, oxygen therapy, etc.The experimental group received additional nebulized inhalation of IFN α1b injection at a dose of 2.0 μg/(kg·time), twice a day.The control group received nebulized inhalation of placebo twice a day.Clinical efficacy was evaluated based on indicators such as the duration of clinical symptoms and signs, and the Kaplan-Meier method was used to calculate the median and 95% CI of the duration of clinical symptoms and signs.The Log-rank test was used to compared data between groups.Safety was assessed through the incidence of adverse reactions and laboratory tests, and the Chi-square test was used to analyze the difference between groups. Results:There were 123 children in the experimental group and 122 children in the control group.The median durations of all the 5 clinical symptoms and signs [including shortness of breath, wheezing, dyspnea (visible retractions), decreased transcutaneous oxygen saturation, and abnormal mental state] in the experimental group after treatment were slightly shortened than those in the control group [2.7 d(95% CI: 1.9-3.0 d)] vs.[2.9 d(95% CI: 2.6-3.6 d), P=0.027].The improvement in dyspnea (retractions) was especially pronounced in the experimental group, with a relief rate of 50.0% (0, 100%) on the first day of administration[compared with 0 (0, 50.0%) in the control group ( Z=2.002, P=0.025)].The median duration of dyspnea in the experimental group was nearly 1 day shorter than that in the control group [1.0 d(95% CI: 0.7-1.7 d) vs.1.8 d(95% CI: 1.0-2.5 d), P=0.046].There were no significant difference in hospital stay [6.0(5.0, 8.0) d vs.6.5(5.0, 8.0) d, Z=0.675, P=0.500], oxygen therapy duration [32.0(14.0, 96.3) h vs.39.0 (24.0, 83.2) h, Z=0.094, P=0.925], the recovery rate from clinical symptoms during treatment [(105/106, 99.1%) vs.(96/101, 95.0%)], and recurrence rate [(0/106, 0) vs.(2/101, 2.0%)] between the 2 groups (all P>0.05).However, the above-mentioned four indicators in the experimental group showed a trend of clinical benefits.The quantitative virus detection results showed that the RSV viral load in both groups decreased after treatment compared to before treatment.After 2 days of treatment, the decline rate of RSV viral load from the baseline was 0.90 lg copies/(mL·d) in the experimental group and 0.25 lg copies/(mL·d)in the control group, with a statistically significant difference ( P<0.05).Furthermore, there was no statistically significant difference in the incidence of adverse reactions between the 2 groups ( P>0.05).Importantly, no drug-related serious adverse reactions occurred in both groups. Conclusions:The nebulized inhalation therapy of IFN α1b demonstrates efficacy and safety in treating pediatric RSV associated lower respiratory tract infections.It particularly offers outstanding clinical therapeutic value for severe children.

Objective:To explore the epidemiological characteristics, imaging findings, pulmonary function changes, dust exposure situations, and treatment outcomes of accelerated silicosis through an analysis of existing literature.Methods:In December 2024, relevant literature from January 1, 1965 to December 15, 2024 was retrieved through the China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, EMbase, and PubMed databases. Keywords included "rapidly progressive silicosis" "accelerated silicosis" "subacute silicosis""artificial stone" and related terms. By incorporating, analyzing, and retrieving data from literatures, a comprehensive review of the epidemiology, clinical features, treatment options, and prognosis of fast forward silicosis was conducted.Results:A total of 72 literatures were included, including 23 cohort studies, 28 case reports, 3 case-control studies, and 18 cross-sectional studies. The average age of all 1794 patients was 33.67 years, with an average dust exposure duration of 5.58 years. The primary occupations associated with accelerated silicosis were stone processing, mining, and artificial quartz stone manufacturing. Imaging findings predominantly included small nodules, ground-glass opacities, and massive fibrosis. Antifibrotic treatment at the early stage of the disease could clearly delay disease progression. However, dust concentrations in workplaces were significantly above safety limits, with inadequate protective measures.Conclusion:Accelerated silicosis is characterized by its rapid onset, swift progression, and unfavorable prognosis. However, it has not garnered adequate attention in the present context. Reliable standard and guidelines are urgently needed to guide clinical diagnosis and treatment.

Objective To investigate whether activation of mitochondrial acetal dehydrogenase 2(ALDH2)alleviates hypoxic pulmonary hypertension by regulating the SIRT1/PGC-1α signaling pathway.Methods Thirty 8-week-old C57 BL/6 mice were randomized into control,hypoxia,and hypoxia+Alda-1(an ALDH2 activator)group(n=10),and the mice in the latter two groups,along with 10 ALDH2 knockout(ALDH2-/-)mice,were exposed to hypoxia(10%O2,90%N2)with or without daily intraperitoneal injection of Alda-1 for 4 weeks.The changes in right ventricular function and pressure(RVSP)of the mice were evaluated by echocardiography and right ventricular catheter test,and pulmonary artery pressure was estimated based on RVSP.Pulmonary vascular remodeling,right ventricular injury,myocardial α-SMA expression,distal pulmonary arteriole muscle normalization,right ventricular cross-sectional area,myocardial cell hypertrophy,and right cardiac hypertrophy index were assessed with HE staining,immunofluorescence staining and WGA staining,and the expressions of ALDH2,SIRT1,PGC-1α,P16INK4A and P21CIP1 were detected.In pulmonary artery smooth muscle cells with hypoxic exposure,the effect of Alda-1 and EX527 on cell senescence and protein expressions was evaluated using β-galactose staining and Western blotting.Results The wild-type mice with hypoxic exposure showed significantly increased RVSP,right ventricular free wall thickness and myocardial expressions of P16INK4A and P21CIP1,which were effectively lowered by treatment with Alda-1 but further increased in ALDH2-/-mice.In cultured pulmonary artery smooth muscle cells,hypoxic exposure significantly increased senescent cell percentage and cellular expressions of P16INK4A and P21CIP1,which were all lowered by treatment with Alda-1,but its effect was obviously attenuated by EX527 treatment.Conclusion ALDH2 alleviates hypoxia-induced senescence of pulmonary artery smooth muscle cells by upregulating the SIRT1/PGC-1α signaling pathway to alleviate pulmonary hypertension in mice.