SMYD5 is a ribosomal methyltransferase with SET and MYND structural domains， which is a member of the SMYD family and is expressed in a variety of tissues， including ovary and testis. This enzyme participates in biological processes such as gene expression regulation， cell development and differentiation， and maintenance of genomic stability through ribosomal protein methylation modification. In recent years， research on SMYD5 has increased in cancers including hepatocellular carcinoma， gastric adenocarcinoma， and lung cancer. Studies have revealed that SMYD5 exhibits high expression levels in various diseases including hepatocellular carcinoma， gastric adenocarcinoma， lung cancer， and inflammatory bowel disease， influencing the progression of these conditions. This review summarizes the role of SMYD5 in hepatocellular carcinoma， inflammatory bowel disease， and other biological functions， aiming to provide a reference for related disease research.

A 20-year-old male patient with T-lymphoblastic lymphoma/leukemia received 9/10 human leukocyte antigen-compatible unrelated peripheral blood stem cell transplantation. He was transplanted with 5.91×10 8 mononuclear cells/kg and 2.88×10 6 CD34 + cells/kg, and neutrophil engraftment was obtained at +11 days and platelet engraftment at +9 days. After transplantation, he presented with repeatedly increased serum creatinine levels, BK virus (BKV) -associated hemorrhagic cystitis, and BKV viremia. BK virus nephropathy was diagnosed based on renal biopsy and metagenomic next-generation sequencing. After adjusting the immunosuppressant, intravenous immunoglobulin, and donor lymphocyte infusion treatment, the patient’s renal function deteriorated progressively, and he eventually died of multiple organ failure at +289 days.

OBJECTIVE To construct an intervention tool for poor compliance of specimen collection and submission before the therapeutic use of antimicrobial agents.METHODS An intervention tool for the poor compliance of spec-imen collection and submission before the therapeutic use of antimicrobial agents was developed through literature review,research group discussions,and two rounds of expert consultations.The tool was subsequently applied in clinical practice to verify its effectiveness.RESULTS The authority coefficient of the consulted experts was 0.95,the feedback rate of the two rounds of expert consultations was 100.00%.The coefficients of variation of the two rounds of consultations were 14.77%and 8.60%,and Kendall's Concordance Coefficients were 0.787 and 0.854(all P<0.05).Finally,an intervention tool for the poor compliance of specimen collection and submission before the therapeutic use of antimicrobial agents was formed,which consisted of 2 first-level items,9 second-level i-tems,and 19 third-level items.After one round of intervention with this tool,the rates of specimen collection and submission before the therapeutic use of antimicrobial agents,the rates of pathogen detection related to healthcare-associated infections,and the rates of pathogen detection before the combined use of key drugs reached the expec-ted targets(69.36%,99.00%and 100.00%,respectively).CONCLUSIONS The intervention tool for the poor compliance of specimen collection and submission before the therapeutic use of antimicrobial agents constructed based on the Delphi method demonstrates high reliability and practicality.It can be used to improve the behavior intervention of specimen collection and submission before the therapeutic use of antimicrobial agents.Moreover,it provides a reference for the intervention strategies in increasing the awareness of specimen collection and submis-sion among the target population,ensuring the correct timing of specimen collection orders,and excuting medical orders at reasonable time nodes.

Objective To investigate the relationship between serum histone deacetylase 3(HDAC3),solu-ble programmed death molecule-1(sPD-1)and Omentin-1 levels with periodontal indexes and prognosis after combined periodontal-orthodontic treatment in patients with periodontitis.Methods A total of 102 patients with periodontitis who were treated in a hospital from September 2018 to May 2020 were selected as the study group.Another 95 healthy subjects who underwent periodontal examination in the same period were selected as the control group.After 6 months of combined periodontal-orthodontic treatment,the patients were divided into poor prognosis group(n=39)and good prognosis group(n=63)according to the results of review.Ser-um levels of HDAC3,sPD-1 and Omentin-1 were detected by enzyme-linked immunosorbent assay.The corre-lation between serum HDAC3,sPD-1,Omentin-1 and periodontal indexes in patients with periodontitis was analyzed by Pearson method.The prognostic value of serum HDAC3,sPD-1 and Omentin-1 in patients with periodontitis after treatment was analyzed by receiver operating characteristic(ROC)curve.Results The ser-um levels of sPD-1,sulcus bleeding index(SBI),plaque index(PLI),loss of attachment(AL)and periodontal probing depth(PD)in the study group were significantly higher than those in the control group,while the ser-um levels of HDAC3 and Omentin-1 were significantly lower than those in the control group,with statistical significance(P＜0.05).Serum sPD-1 levels were positively correlated with periodontal indicators SBI,PLI,AL and PD,while serum HDAC3 and Omentin-1 levels were negatively correlated with periodontal indicators SBI,PLI,AL and PD(P＜0.05).Before treatment,PD,PLI,alveolar bone height and serum sPD-1 level in the poor prognosis group were significantly higher than those in the good prognosis group,while serum HDAC3 and Omentin-1 levels were significantly lower than those in the good prognosis group,with statistical signifi-cance(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)predicted the prognosis of periodontitis patients after treatment by the combination of serum HDAC3,sPD-1 and Omentin-1 was better than the AUC predicted by serum HDAC3,SPD-1 and Omentin-1 alone(Z three combination-HDAC3=2.754,Z three combination-sPD-1=3.415,Z three combination-Omentin-1=3.355,P=0.006,0.001,0.001).Conclusion The serum level of sPD-1 in patients with periodontitis is significantly increased,and the serum levels of HDAC3 and Omentin-1 are significantly decreased,which are closely related to periodontal indexes.The combination of the three has a good predictive value for the prognosis of patients with periodontitis after treatment.

Objective:To investigate the value of machine learning models based on CT radiomics for predicting the outcome of neoadjuvant chemotherapy (NAC) in patients with locally advanced gastric cancer (LAGC).Methods:A retrospective case series study was conducted. A total of 279 LAGC patients receiving NAC before surgery in Shanxi Province Cancer Hospital from January 2018 to November 2020 were included. According to a ratio of 7∶3, all patients were randomly divided into the training set (196 cases) and the validation set (83 cases). According to the tumor regression grade (TRG), the pathological grade was divided into the good response of NAC (GR) group (TRG 0-1, 55 cases) and the poor response of NAC (PR) group (TRG 2-3, 224 cases). The clinicopathological data of patients were collected, such as age, gender, differentiation degree, clinical T and N staging, carcinoembryonic antigen (CEA), and carbohydrate antigen 199 (CA199) level. Radiomics features were extracted from the enhanced CT images in the vein phase, and the features were screened by 3-step dimensionality reduction. And then 5 machine learning algorithms including logistic regression (LR), naive bayes (NB), random forest (RF), support vector machine (SVM) and extreme gradient boosting (XGB) were applied to build prediction models based on the CT radiomics. The receiver operating characteristic (ROC) curve and the decision analysis (DCA) curve were drawn to evaluate the predictive performance and clinical benefit of each model on the outcome of NAC in patients with LAGC.Results:Among 196 patients in the training set, there were 39 cases in GR group and 157 cases in PR group; among 83 patients in the validation set, there were 16 cases in GR group and 67 cases in PR group. There were no statistically significant differences in clinicopathological data of patients between the training and validation sets, or between GR and PR groups in the training and validation sets (all P > 0.05). A total of 102 radiomics features were extracted from region of interest of CT images in the vein phase, and 6 key features were finally selected including original_firstorder_10Percentile, original_firstorder_RoubustMeanAbsoluteDeviation, original_glcm_Idmn, original_glcm_MCC, original_ngtdm_Busyness, original_ngtdm_Contrast; and there were statistically significant differences in 6 features between the GR and PR groups (all P < 0.05). LR, NB, RF, SVM and XGB machine learning algorithms were used to construct 5 prediction models based on the CT radiomics. The area under ROC curve for NAC prediction in the training set was 0.553, 0.709, 0.668, 0.772 and 0.790, respectively; in the validation set was 0.662, 0.622, 0.683, 0.752 and 0.784, respectively. The model constructed by XGB showed the best comprehensive performance, and its accuracy, sensitivity and specificity was 0.771, 0.562 and 0.821, respectively. In the DCA of 5 machine learning models in the training set, XGB-based model provided a higher net benefit. Conclusions:Machine learning models based on enhanced CT radiomics in the vein phase have a high predictive efficacy in the outcome of NAC in LAGC patients before surgery and it helps make clinical personalized treatment decisions.

Objective:To analyze the clinical characteristics and treatment outcomes of central nervous system（CNS）mucormycosis following allogeneic hematopoietic stem cell transplantation（allo-HSCT）.Methods:Clinical data of 6 patients diagnosed with CNS mucormycosis after allo-HSCT at Henan Cancer Hospital between January 2020 and December 2024 were retrospectively collected. The patients' clinical manifestations，laboratory findings，imaging features，treatment regimens，and outcomes were analyzed.Results:The incidence of CNS mucormycosis post-allo-HSCT was 0.7%（6/851）. The main clinical manifestations included impaired consciousness（5 cases），convulsions（3 cases），headache（2 cases），hemiplegia（1 case），ptosis（1 case），and mydriasis with sluggish light reflex and incomplete eye closure（1 case）. The median time from transplantation to the onset of neurological symptoms was 138 days（94-572 days）. Metagenomic next-generation sequencing（mNGS）of cerebrospinal fluid identified Rhizopus spp.（2 cases）， Rhizomucor spp.（2 cases），and Absidia spp.（2 cases）. Cranial MRI performed in five patients revealed multiple mass or patchy lesions in various regions；one patient underwent cranial CT，which showed patchy hypodense lesions in multiple areas. All patients received antifungal therapy，with 2 cases receiving combined intrathecal injection of amphotericin B liposomes；five patients died，and one survived. Conclusions:CNS mucormycosis is a rare but severe complication after allo-HSCT. Its clinical and radiological features are non-specific，posing diagnostic challenges. Intravenous administration of liposomal amphotericin B at full dosage，combined with intrathecal injection，may improve treatment efficacy.

Objective:To explore the clinical and genetic characteristics of two children diagnosed with two rare genetic diseases simultaneously.Methods:Two children with comorbidity of two genetic diseases due to dual genetic mutations diagnosed at the Third Affiliated Hospital of Zhengzhou University respectively in May 2022 and March 2023 were selected as the study subjects. Clinical and genetic data of the two children were retrospectively analyzed. This study has been approved by the Ethics Committee of the Third Affiliated Hospital of Zhengzhou University (Ethic No. 2021-062-01).Results:Child 1 was a 2-year-and-4-month-old boy whose clinical manifestations included facial dysmorphism, developmental delay, short stature, microcephaly, cleft palate, cryptorchidism, hypospadias, recurrent infections and immunological abnormalities. Whole exome sequencing revealed that he had harbored a heterozygous c.6595delT (p.Y2199Ifs*65) variant of the KMT2D gene and a heterozygous c. 1892G>A (p.R631Q) variant of the PIK3R1 gene. This has led to a dual genetic diagnosis of Kabuki syndrome and PI3Kδ-related immunodeficiency type 36. Child 2 was a 15-year-old girl whose clinical manifestations included epilepsy, Albright′s hereditary osteodystrophy, long body trunk, short limbs, hypocalcemia, hyperphosphatemia and hyperparathyroidism. The child also had a family history of short stature. Whole exome sequencing revealed that she had harbored a heterozygous c. 2T>C (p.Met1? ) variant of the GNAS gene and deletion of exons 2 to 6 of the SHOX gene. The two variants have led to dual diagnose of pseudohypoparathyroidism and X-linked idiopathic short stature. Conclusion:When the clinical phenotype of a genetic disease is complex and cannot be fully explained with a single genetic variant, multiple pathogenic variants should be considered, and this may lead to the diagnosis of co-morbid genetic diseases. To adopt or supplement corresponding genetic testing in time and re-analyze the genetic data may facilitate accurate diagnosis of comorbid genetic diseases.

Objective:To analyze the association between continuity of consultation and the management of glycosylated hemoglobin (HbA1c) in diabetes patients contracted by family doctors.Methods:This study was a cross-sectional study. From May 2022 to October 2022, three community health service centers in the urban area of Beijing were selected by convenient sampling. A total of 360 diabetes patients were selected by simple random sampling from the selected centers. Extraction of data from electronic health records were conducted to collect patient characteristics, information on the continuity evaluation indicators for patient visits (usual provider of care, UPC) in 2021 and information of monitoring and control indicators for HbA1c in 2021. The monitoring and control of HbA1c in patients with different continuity of consultations were compared. Chi-square test and logistic regression analysis were used to determine the association between continuity of consultation and HbA1c management (i.e., HbA1c monitoring and control).Results:Of the 360 patients, 167 (46.4%) were male; the age was 68.0 (60.0, 74.0) years and the number of years since diagnosis was 11.0 (7.0, 17.0) years. One hundred and fifty-nine patients (44.1%) had UPC scores below 30%, 101 patients (28.1%) had UPC scores between 30% and 50%, and 100 patients (27.8%) had UPC scores above 50%. The compliance rate for HbA1c monitoring was 66.4% (239/360), and the compliance rate for HbA1c control was 45.8% (165/360). When the UPC score was less than 30%, between 30%-50%, and greater than 50%, the HbA1c monitoring compliance rates were 53.5% (85/159), 73.3% (74/101), and 80.0% (80/100), respectively, and the HbA1c control compliance rates were 37.7% (60/159), 51.5% (52/101), and 53.0% (53/100), respectively, and the differences were statistically significant ( χ2=22.36, 7.57, P<0.05). As the UPC score increased, the likelihood of achieving HbA1c monitoring ( OR=1.020, 95% CI:1.009-1.030 , P<0.001) and control ( OR=1.012, 95% CI:1.003-1.021 ,P=0.008) targets increased. Conclusion:There is an association between the continuity of consultation and the management of HbA1c.

Community general practitioners are the main force of primary health care, however, the lack of effective incentive mechanisms would affect their work enthusiasm. Therefore, to enhance incentive mechanisms,particularly from the perspective of the career development,will improve the work enthusiasm and post competeny of general practitioners in primary health care services. This article summarizes five major influencing factors of the incentives for community general practitioners, namely salary and benefits, performance evaluation, promotion and development, working conditions and interpersonal relationships, and proposes the operational strategies of incentive improvement, to provide reference for improving working conditions and strengthening incentive measures for community general practioners in primary community hospitals.

A 20-year-old male patient with T-lymphoblastic lymphoma/leukemia received 9/10 human leukocyte antigen-compatible unrelated peripheral blood stem cell transplantation. He was transplanted with 5.91×10 8 mononuclear cells/kg and 2.88×10 6 CD34 + cells/kg, and neutrophil engraftment was obtained at +11 days and platelet engraftment at +9 days. After transplantation, he presented with repeatedly increased serum creatinine levels, BK virus (BKV) -associated hemorrhagic cystitis, and BKV viremia. BK virus nephropathy was diagnosed based on renal biopsy and metagenomic next-generation sequencing. After adjusting the immunosuppressant, intravenous immunoglobulin, and donor lymphocyte infusion treatment, the patient’s renal function deteriorated progressively, and he eventually died of multiple organ failure at +289 days.