Objective:To evaluate the role of minimal residual disease (MRD) monitoring during early induction therapy for the treatment of childhood acute lymphoblastic leukemia (ALL).Methods:This was a multicenter retrospective cohort study. Clinical data of 1 164 ALL patients first diagnosed between October 2016 and June 2019 was collected from 16 hospitals in South China Children′s Leukemia Group. According to MRD assay on day 15 of early induction therapy, they were divided into MRD<0.10% group, MRD 0.10%-<10.00% group and MRD≥10.00% group. According to MRD assay on day 33, they were divided into MRD<0.01% group, MRD 0.01%-<1.00% group and MRD≥1.00% group. Age, onset white blood cell count, central nervous system leukemia (CNSL), molecular genetic characteristics and other data were compared between groups. Kaplan-Meier method was used for survival analysis. Cox regression model was used to analyze prognostic factors.Results:Of the 1 164 enrolled patients, there were 692 males and 472 females. The age of diagnosis was 4.7 (0.5, 17.4) years. The white blood cell count at initial diagnosis was 10.7 (0.4, 1 409.0) ×10 9/L. Among all patients, 53 cases (4.6%) had CNSL. The follow-up time was 47.6 (0.5, 68.8) months. The 5-year overall survival (OS) and 5-year relapse-free survival (RFS) rates were (93.1±0.8) % and (90.3±1.1) %. On day 15 of early induction therapy, there were 466 cases in the MRD<0.10% group, 523 cases in the MRD 0.10%-<10.00% group and 175 cases in the MRD≥10.00% group. The 5-year OS rates of the MRD<0.10% group, MRD 0.10%-<10.00% group and MRD≥10.00% group were (95.4±1.0) %, (93.3±1.1) %, (85.4±2.9) %, respectively, while the RFS rates were (93.2±1.6) %, (90.8±1.4) %, (78.9±4.3) %, respectively ( χ2=16.47, 21.06, both P<0.05). On day 33 of early induction therapy, there were 925 cases in the MRD <0.01% group, 164 cases in the MRD 0.01%-<1.00% group and 59 cases in the MRD≥1.00% group. The 5-year RFS rates in the MRD 0.01%-<1.00% group was lowest among three groups ((91.4±1.2) % vs. (84.5±3.2) % vs. (87.9±5.1) %). The difference between three groups is statistically significant ( χ2=9.11, P=0.010). Among ALL patients with MRD≥10.00% on day 15 of induction therapy, there were 80 cases in the MRD <0.01% group on day 33, 45 cases in the MRD 0.01%-<1.00% group on day 33 and 45 cases in the MRD≥1.00% group on day 33. The 5-year RFS rates of three groups were (83.9±6.0)%, (67.1±8.2)%, (83.3±6.9)% respectively ( χ2=6.90, P=0.032). Univariate analysis was performed in the MRD≥10.00% group on day 15 and the MRD 0.01%-<1.00% group on day 33.The 5-year RFS rate of children with CNSL was significantly lower than that without CNSL in the MRD≥10.00% group on day 15 ((50.0±20.4)% vs. (80.3±4.4)%, χ2=4.13, P=0.042). Patients with CNSL or MLL gene rearrangement in the MRD 0.01%-<1.00% group on day 33 had significant lower 5-year RFS rate compared to those without CNSL or MLL gene rearrangement ((50.0±25.0)% vs. (85.5±3.1)%, χ2=4.06, P=0.044;(58.3±18.6)% vs. (85.7±3.2)%, χ2=9.44, P=0.002). Multivariate analysis showed that age ( OR=0.58, 95% CI 0.35-0.97) and white blood cell count at first diagnosis ( OR=0.43, 95% CI 0.27-0.70) were independent risk factors for OS. The MRD level on day 15 ( OR=0.55,95% CI 0.31-0.97), ETV6-RUNX1 fusion gene ( OR=0.13,95% CI 0.03-0.54), MLL gene rearrangement ( OR=2.55,95% CI 1.18-5.53) and white blood cell count at initial diagnosis ( OR=0.52,95% CI 0.33-0.81) were independent prognostic factors for RFS. Conclusions:The higher the level of MRD in early induction therapy, the worse the OS. The MRD levels on day 15 is an independent prognostic factor for RFS.The MRD in early induction therapy guided accurate risk stratification and individualized treatment can improve the survival rate of pediatric ALL.

Breast cancer is the most common cancer in women and one of the deadliest cancers worldwide.According to the distribution of tumor tissue,breast cancer can be divided into invasive and non-invasive forms.The cancer cells in invasive breast cancer pass through the breast and through the immune system or systemic circulation to different parts of the body,forming metastatic breast cancer.Drug resistance and distant metastasis are the main causes of death from breast cancer.Research on breast cancer has attracted extensive attention from researchers.In vitro construction of tumor models by tissue engineering methods is a common tool for studying cancer mechanisms and anticancer drug screening.The tumor microenvironment consists of cancer cells and various types of stromal cells,including fibroblasts,endothelial cells,mesenchymal cells,and immune cells embedded in the extracellular matrix.The extracellular matrix contains fibrin proteins(such as types Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅵ,and Ⅹcollagen and elastin)and glycoproteins(such as proteoglycan,laminin,and fibronectin),which are involved in cell signaling and binding of growth factors.The current traditional two-dimensional(2D)tumor models are limited by the growth environment and often cannot accurately reproduce the heterogeneity and complexity of tumor tissues in vivo.Therefore,in recent years,research on three-dimensional(3D)tumor models has gradually increased,especially 3D bioprinting models with high precision and repeatability.Compared with a 2D model,the 3D environment can better simulate the complex extracellular matrix components and structures in the tumor microenvironment.Three-dimensional models are often used as a bridge between 2D cellular level experiments and animal experiments.Acellular matrix,gelatin,sodium alginate,and other natural materials are widely used in the construction of tumor models because of their excellent biocompatibility and non-immune rejection.Here,we review various natural scaffold materials and construction methods involved in 3D tissue-engineered tumor models,as a reference for research in the field of breast cancer.

Organ transplantation is the most effective treatment for various types of end-stage diseases. To resolve the problem of donor shortage in organ transplantation, the possibility of xenotransplantation has been gradually explored by surgeons. Pig is one of the common donor sources for xenotransplantation. As a bridge between two species, the viruses carried by pig organs may be transmitted between species and cause the risk of zoonosis. Porcine endogenous retrovirus (PERV) is integrated into the genome, which is a category of retrovirus featuring cross-species transmission. In this article, the influencing factors of transmission characteristics of PERV, the transmission risk of PERV and its recombinant virus, and the detection and transmission risk assessment of PERV in xenotransplantation test were reviewed, aiming to provide reference for alleviating severe shortage of donor organs and driving the advancement of xenotransplantation technologies.

Objective:To explore the risk factors affecting the incidence of acute kidney injury(AKI)after liver transplantation(LT).Methods:From November 2019 to November 2022, clinical data were retrospectively reviewed for 105 recipients of classic orthotopic LT.There are 89 males and 16 females with an age range of(50.52±10.35)years.They are assigned into two groups of AKI(66 cases)and non-AKI(39 cases)according to the AKI diagnostic and staging criteria of Global Kidney Disease Prognosis Organization in 2012.General profiles and clinical data(e.g.previous medical history, MELD score, total bilirubin, albumin, serum creatinine level, coagulation function, anhepatic phase and time to surgery)of two groups of recipients are compared.The factors with statistically significant differences are included into multivariate Logistic regression analysis for obtaining independent risk factors for early AKI post-LT.Results:Among them, 66 patients developed AKI within 7 days post-operation with an incidence rate of 62.86%(66/105).The clinical stages of AKI are Ⅰ(46 cases, 69.70%), Ⅱ(10 cases, 15.15%)and Ⅲ(10 cases, 15.15%).Statistically significant inter-group differences exists in age, abdominal surgery history, preoperative serum level of creatinine, operative duration, anhepatic phase and intraoperative plasma transfusion(all P<0.05).Multivariate Logistic regression analysis indicated that abdominal surgery history( OR=5.803, 95% CI: 1.008~33.401, P=0.049), anhepatic phase( OR=1.054, 95% CI: 1.008~1.101, P=0.020)and preoperative serum level of creatinine( OR=0.968, 95% CI: 0.943~0.994, P=0.016)are independent risk factors for early AKI after classical orthotopic LT recipients. Conclusions:Abdominal surgery history, anhepatic phase, and preoperative serum level of creatinine are independent risk factors for early AKI in classic orthotopic LT recipients.

Organ transplantation is the most effective treatment for all categories of end-stage organ diseases. To resolve the shortage of donors in organ transplantation, widespread attention has been diverted to xenotransplantation. At present, clinicians mainly highlight the problems related to xenotransplantation rejection and viral infection. The physiology of xenotransplantation has been rarely studied. Kidney performs endocrine function by producing erythropoietin (EPO), renin and activating vitamin D. Although these pathways are usually well preserved in allogeneic transplantation, species-specific differences, especially those between pigs and non-human primates, may still affect the physiological function of transplant organs. In this article, the changes of EPO, renin-angiotensin-aldosterone system (RAAS) and active vitamin D₃ of pig and human after xenotransplantation were illustrated, aiming to provide reference for subclinical research of xenotransplantation.

Objective Lab color mode can be used to digitize the color.This study explores the possibility of using Lab model to measure facial pigmentations.Methods Lab color model was used to measure the normal skin and three common clinical pigmentations (Ota nevus,freckles and melasma).We also analyzed the characteristics and assessed the data changes after the treatment.Results Average L,a and b values were 54.4,13.8 and 19.0 in normal skin,34.6,5.17 and 6.9 in Ota nevus,43.25,16.15 and 23.05 in freckles and 40.5,16.8 and 23.35 in melasma,respectively.The Lab values of freckles and melasma were close.The order of L value was:normal skin ＞ freckle ＞ melasma ＞Ota nevus;the order of value of a and b was:melasma ＞ freckle ＞ normal skin ＞ Ota nevus.After treatment,the Lab values gradually tended to be the values of normal skin.Conclusions The Lab color mode can be used as a digital description method for skin color and facial pigmentation,which provides an objective measure for clinical research.

Objective To explore the clinical features and treatment of skin ulcers.Methods A total of 185 skin ulcer patients with clinical data was analyzed retrospectively in our hospital from October 2014-October 2016.Results Of the 185 patients with skin ulcers,84(45.4％) were 51-70 years old,diabetic ulcers were most common,and most occurred in ankle (44.3％) and limbs (35.7％).After further statistical analysis,the healing rate of patients treated by surgery was significantly higher than non-surgical patients.Surgical procedures of local flap transfer after ulcer resection were most commonly used and of the highest healing rate.The number of ulcers,the largest diameter of ulcers,scar ulcers and blood barrier ulcers were four factors that were independent of the outcome of skin ulcers.Conclusions Skin ulcers hospitalized patients are more common in patients over 50 years of age,occur most in the lower limbs.Surgical therapy is the preferred treatment for most ulcers,of which local flap transfer after ulcer resection has the best effect.Ulcer patients should actively treat the primary disease,strengthen the care,early diagnosis,and early treatment.

Objective T o explore the effectiveness of direct am plification for the ST R analysis of carti-lage, and to accelerate the effectiveness of disaster victim identification. Methods E ighty-eight cartilage sam ples w ere directly am plified by Pow erPlex誖21 kit, and the results of genotyping w ere com pared w ith that obtained by the m agnetic beads m ethod. Results In 88 cartilage sam ples, the ST R genotypes w ere successfully detected from 84 sam ples by direct am plification and m agnetic beads m ethod, and both the results of genotyping by tw o m ethod w ere consistent. Conclusion D irect am plification w ith Pow er-Plex誖21 kit can be used for ST R genotyping of cartilages. T his m ethod is operated easily and prom ptly, w hich has a potential application in the individual identification of m ass disasters.

Objective To investigate the effects of the structural psychological nursing on the sense of uncertainty and adverse cardiovascular events (ACE) in patients with PCI.Methods Totals of 98 PCI patients who admitted to the Cardiology Department of Affiliated Hospital of Binzhou Medical College from June 2015 to May 2016 were selected into the study. The participants were divided into the control group (n=49) and the intervention group (n=49) according to a random number table. Based on the routine nursing care, the intervention group received an additional structural psychological care. To compare the state of pre operative mood and postoperative mood, the sense of uncertainty one day before and after PCI, and the incidence of ACE three months after PCI between the two groups.Results Patients in the intervention group had a better state of mood after the intervention compared with the control group. The sense of uncertainty was similar before the operation (P>0.05) but was significantly different between the two groups after the operation (t=4.635, 3.265, 4.012;P<0.01). In the intervention group, the scores of undefined diagnosis, complexity, and sense of uncertainty to the disease was (35.63±5.96), (21.26±3.01) and (56.89±5.84). After three months, the vasovagal reflectivity and incidence of hematoma on the puncture site had significant differences between the two groups (P<0.05), but had limited difference in the incidence of myocardial infarction or angina recurrence rate (P>0.05).Conclusions The structural psychological nursing can effectively prevent the sense of uncertainty and adverse cardiovascular events in patients with PCI.

Objective To compare the effect of three-point positioning method and traditional puncture method in patients with arteriovenous fistula in hemodialysis.Methods A total of 800 hemodialysis patients with malignant tumor of urinary system in our hospital were divided into three-point positioning method group (observation group) and traditional puncture method group (control group), with 400 cases in each group.All the puncture was performed by the senior nurses with color Doppler, and vein intima thickness of artery fistula before puncture and 60 times after puncture were observed, puncture failure rate, incidence of venous fistula aneurysm, arteriovenous fistula stenosis and satisfaction were compared.Results There was no significant difference in vein intima thickness of artery fistula(P<0.05);The effect degree of vein intima thickness of artery fistula in the observation group after treatment was significantly lower than that of the control group, and the difference was statistically significant(P<0.05);The puncture failure rate, incidence of arteriovenous fistula aneurysm, and arteriovenous fistula stenosis rate in the observation group after 60 times puncture were significantly lower than that in the control group, and the differences were statistically significant(P<0.05);The satisfaction in the observation group was significantly higher than that in the control group, the difference was statistically significant (P<0.05).Conclusion Three-point positioning puncture combined with losartan has significant effect for arteriovenous fistula patients with the malignant tumor of urinary system, and it can effectively prolong longevity of vascular puncture, and reduce complications of vascular with fistula.