Objective:To investigate effective strategies to reduce the high risk of recurrence after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in patients with minimal residual disease(MRD)-positive B-lineage acute lymphoblastic leukemia(B-ALL).Methods:A retrospective analysis was performed for ten B-ALL patients with positive MRD before transplantation at our center from November 2022 to November 2024.There were four male patients and six female patients,with a median age of 30(7-56)years.Of all patients,four received transplantation from unrelated donors,and six received haploidentical transplantation from relatives.All ten patients received blinatumomab(28 μg/day for 14 days for patients≥45 kg;5 μg/m2/day for 14 days for patients<45 kg)and were bridged to the conditioning regimen for allo-HSCT within 7 days.Results:After treatment with blinatumomab,all ten patients achieved the clearance of MRD.After allo-HSCT,100%of the patients achieved donor hematopoietic reconstitution.The median time to neutrophil reconstitution was 12(9-22)days,and the median time to platelet reconstitution was 13.5(9-22)days.As of January 2025,the median observation time was 14(2-26)months;of all patients,two experienced recurrence,and one had positive MRD again,with a recurrence rate of 20%.Among the ten patients,nine survived and one died of disease recurrence.One patient achieved complete re-mission again after chimeric antigen receptor T-cell(CAR-T)therapy following recurrence,and the patient with positive MRD achieved the clearance of MRD again after interleukin-2 treatment;both patients were currently alive.During treatment,one patient developed cytokine release syndrome,one patient was comorbid with SARS-CoV-2 infection,one patient had herpes zoster and viral encephalitis,three patients developed grade Ⅰ-Ⅱ acute graft-versus-host disease,and four patients developed chronic graft-versus-host disease;no transplantation-associated thrombotic microangiopathy was observed.Conclusion:For patients with MRD-positive B-ALL,blinatumomab as a bridge therapy for allo-HSCT can significantly reduce recurrence after transplantation,with fewer complica-tions that are easy to control.Multicenter randomized controlled clinical studies can be performed to further verify its efficacy and safety.

OBJECTIVE To establish an ion chromatography method for the simultaneous determination of chloride， sulfate and bicarbonate ions in Polyethylene glycol electrolyte powder （Ⅲ）. METHODS The chromatographic column was a Dionex IonpacTM AS11-HC anion analysis column， with a Dionex IonPacTM AG11-HC guard column. The mobile phase was 10 mmol/L potassium hydroxide at an isocratic elution flow rate of 1.2 mL/min. The detector was a conductivity detector， and the suppressor was a Dionex AERS with a suppressor current of 30 mA. The column temperature was maintained at 30 ° C， and the injection volume was 10 μL. Chloride and sulfate contents were calculated by external standard method， while bicarbonate content was determined by double logarithmic fitting standard curve method. RESULTS Under these chromatographic conditions， chloride， sulfate and bicarbonate ions were effectively separated with linear ranges of 0.055 to 0.219 mg/mL （r＝0.999 9）， 0.155 to 0.618 mg/mL （r＝1.000 0）， and 0.065 to 0.121 mg/mL （r＝0.999 9）， respectively. The recoveries were 98.06% to 101.34%， 97.37% to 101.25%， and 97.16% to 99.81%， respectively， with RSDs of 1.1%， 1.3% and 1.0% （n＝9）. The RSDs for the evaluation of precision， accuracy， stability and ruggedness were all less than 2%. CONCLUSIONS The established ion chromatography is simple， rapid， accurate， precise and durable， can simultaneously determine the contents of chloride， sulfate and bicarbonate ions in Polyethylene glycol electrolyte powder （Ⅲ）， which is suitable for its quality control.

Evidence-based medicine (EBM) is a science that uses the best available research data to make decisions, and the core is that clinical decision-making is supported by the best research evidence. Incorporating EBM into traditional standardized residency training in hematology can foster residents' professional theoretical knowledge and clinical skills, improve the quality of standardized training, and provide ideas and methods for standardized training of hematology residents, which is worthy of further research and exploration.

Natural killer (NK) cells, a type of cytotoxic lymphocytes, can infiltrate into ischemic brain and exacerbate neuronal cell death. Astragaloside IV (ASIV) is the major bioactive ingredient of Astragalus membranaceus, a Chinese herbal medicine, and possesses potent immunomodulatory and neuroprotective properties. This study investigated the effects of ASIV on post-ischemic brain infiltration and activation of NK cells. ASIV reduced brain infarction and alleviated functional deficits in MCAO rats, and these beneficial effects persisted for at least 7 days. Abundant NK cells infiltrated into the ischemic hemisphere on day 1 after brain ischemia, and this infiltration was suppressed by ASIV. Strikingly, ASIV reversed NK cell deficiency in the spleen and blood after brain ischemia. ASIV inhibited astrocyte-derived CCL2 upregulation and reduced CCR2
Animals ; Brain ; Histone Deacetylases ; Killer Cells, Natural ; Rats ; Saponins/pharmacology* ; Triterpenes/pharmacology*

Objective To investigate the value of laparoscopy in the treatment of children with cryptorchidism.Methods Clinical data of 76 children with middle and high cryptorchidism were retrospectively analyzed,in which 41 cases were treated by traditional operation,and 35 cases underwent laparoscopic testicular descending fixation.The operative time,hospitalization time and incidence rate of postoperative complications were compared.Results Compared with open surgery,the laparoscopic testicular fixation had less traumatic,faster recovery and few postoperative complications such as testicular retraction.Conclusion Compared with open surgery,laparoscopic testicular descending fixation has obvious advantages,and it can be considered as the first choice for high and middle cryptorchidism.

Objective To investigate the value of laparoscopy in the treatment of children with cryptorchidism.Methods Clinical data of 76 children with middle and high cryptorchidism were retrospectively analyzed,in which 41 cases were treated by traditional operation,and 35 cases underwent laparoscopic testicular descending fixation.The operative time,hospitalization time and incidence rate of postoperative complications were compared.Results Compared with open surgery,the laparoscopic testicular fixation had less traumatic,faster recovery and few postoperative complications such as testicular retraction.Conclusion Compared with open surgery,laparoscopic testicular descending fixation has obvious advantages,and it can be considered as the first choice for high and middle cryptorchidism.

Objective To establish a human HepG2 cell growth model under the low oxygen environment induced by cobalt chloride in order to observe the impacts of human HepG2 cell proliferation,cellular cycles and apoptosis,namely cellular growth conditions,under the low oxygen environment induced by cobalt chloride with different concentrations and to study the HepG2 cell growth mechanism under the low oxygen environment induced by cobalt chloride.Methods The human HepG2 cells in the logarithmic phase were randomized grouping as control group and CoCl2 experimental group with different concentrations (50 μm/L,100 μm/L,150 μm/L and 200 μm/L).① HepG2 cell proliferation was tested by MTT assay to calculate cell's suppression rate and draw HepG2 cell growth inhibition curves.② The move ability of HepG2 cells was observed by scratch test.③ The cellular apoptosis and periodic changes were detected using the flow cytometer Annexin-V FITC/PI double-staining and PI single staining methods.④HepG2 cell's Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and Bcl-2 protein expression were detected by Western Blot.Results ① The test results obtained via MTT assay showed that CoCl2 suppressed the human HepG2 cell proliferation within a certain amount of time and concentration and presented a time-dose dependent relation.② Scratch damage trial suggested that the cobalt chloride suppressed the HepG2 cell migration and wound repair capacity and presented a concentration dependent relation.③ Flow cytometer' s test results revealed that the apoptosis rates (％) in control group and experimental group with different concentrations (50 μm/L,100 μm/L,150 μm/L and 200 μm/L) were 3.42,7.74,13.07,20.56,28.53 and 44.45 (P ＜0.05),respectively.The apoptosis rate of the experimental group was significantly increased compared with the control group,as well as showing a concentration dependency.The results of cellular cycles revealed that the cobalt chloride significantly suppressed the HepG2 cell's periodic changes along with increases of concentration,as well as blocked the cell cycle staying in phase G1,thereby suppressing cell proliferation.④Western Blot test:Compared with the control group,the Bcl-2 protein expression was significantly decreased in the experimental group after treatment of cobalt chloride with different concentrations.Conclusion Within a certain range,CoC12-indiuced low oxygen environment can suppress the human HepG2 cell proliferation and healing migration capacity,induce apoptosis and present a time-dose dependent relation.The mechanism is likely associated with decreases of Bcl-2 protein expression.

BACKGROUNDThe glucose fluxes of individuals with prediabetes in Chinese population are not clear. This study was to determine whether the endogenous glucose production (EGP), oral glucose rate of appearance (Ra) and glucose rate of disappearance (Rd) were different in Chinese individuals with prediabetes under fasting conditions and following an oral glucose challenge.

METHODSFive subjects with type 2 diabetes, 5 subjects with prediabetes and 5 non-diabetic subjects matched for age, weight, fat free mass and body mass index underwent a 180 minute stable glucose isotope tracing ([6, 6-(2)H2] glucose, [1-(13)C] glucose, and [U-(13)C] glucose) study under fasting and after ingestion of a 75 g oral glucose load. Isotope glucose enrichment was measured by gas chromatography-mass spectrometry. Insulin sensitivity was estimated using the oral glucose tolerance test (OGTT)-derived insulin sensitivity index, β cell function was determined by the insulinogenic index (δI30/δG30).

RESULTSThe insulin sensitivity index (P = 0.043) and insulinogenic index (P = 0.021) were decreased in subjects with prediabetes compared with non-diabetes. Fasting EGP was slightly higher (P = 0.29) and postprandial EGP was comparable in subjects with prediabetes and non-diabetes during 120 minutes after glucose ingestion, but nadir EGP occurred later in prediabetic than non-diabetic subjects. Ra did not differ among the three groups. Rd was substantially lower in subjects with prediabetes than non-diabetes after glucose intake (P = 0.013).

CONCLUSIONThe mild hyperglycemia observed among individuals with prediabetes may result from decreased Rd during the postprandial state.

Blood Glucose ; metabolism ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; blood ; Fasting ; blood ; Female ; Glucose ; metabolism ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; blood ; Isotope Labeling ; Male ; Middle Aged ; Prediabetic State ; blood

Objective To explore the impact and significance of hypoxia preconditioning on the expression of cytochrome C and caspase 3 protein in rats after hepatic resection.Methods A hepatectomy model was used to study the ischemia reperfusion injury in hepatic resection.Sprague-Dawley rats were randomly divided into the following three groups:normal control (NC) group,hepatic resection(HR) group,and hypoxia preconditioning (HP) group,there were twenty four rats in each group.HP Group was given an 10％ oxygen-mixed gas for 90 minutes before the operation.At 1,6,12 and 24 hours after the operation,the rats were killed and the following tests were conducted:(1) Liver tissue was sampled to observe the expression of cytochrome C and caspase 3 protein; (2) blood was drawn to conduct a chemical examination; (3) Liver tissue and morphology was observed by transmission electron microscopy.Results The serum levels of ALT and AST in HP group were significantly lower than that of HR group (P＜0.05) at 1,6,12 and 24 hours after the hepatic resection.In each time,liver function of the HP group was significantly better than the HR group; The expression of cytochrome C and caspase 3 protein was decreased significantly in HP group at each measurement point.Hepatic cells in HR group showed typical apoptosis signs under transmission electron microscopy (TEM),but no apoptosis was found in HP group.Conclusion HP has marked inhibition to apoptosis by down-regulating the expression of Cyt C and Caspase-3protein and protection to chondrosomes after a hepatic resection.

Objective To observe the effects of intermittent hypoxic preconditioning on the expression of apoptosis-related Bcl-2 and Bax protein after 70％ hepatectomy combined with ischemia-reperfusion injury.Methods A total of fifty-four SD rats were randomly divided into three groups (n =18).Partial hepatectomy hroup (PH Group):Rats underwent the left and middle lobectomy of liver(70％ hepatectomy).Ischemia reperfusion group (IR group):The left and middle lobes of liver were resected during the occlusion of the hepatoduodenal ligament for 20 minutes.Residual liver underwent the process of ischemia-reperfusion.Intermittent hypoxia preconditioning group (IHP group):rats were exposed to hypoxic environment of 10％ oxygen for 1 h/d.After 7 consecutive days,the left and middle lobes of liver were resected under the portal triad clamping.At 12,24 and 48 hours after the operation,the rats were killed and detected.The serum levels of ALT and AST were determined by automatic biochemical analyzer.The expression of Bcl-2 and Bax protein in liver tissue were measured by immunohistochemistry.Results At each time point after surgery,the serum levels of ALT and AST in IR group and IHP group were higher than that of PH group,and IHP group were lower than in IR group.Compared with IR group,the expression of Bcl2 protein significantly increased and Bax protein expression significantly decreased in IHP group.All these differences were statistically significant (P ＜ 0.05).Conclusions Intermittent hypoxic preconditioning might protect residual liver against ischemia reperfusion injury,through increasing the expression of Bcl-2 protein and reducing the expression of Bcl-2 protein to decrease liver cell apoptosis.