1.Core signaling axes of TGF-β-mediated scleral remodeling and their significance in myopia progression
International Eye Science 2026;26(7):1228-1233
Myopia is a globally prevalent refractive eye disease, with abnormal axial elongation as its core structural feature, and scleral remodeling is the key terminal event driving axial elongation. Transforming growth factor-β(TGF-β), as a core cytokine regulating tissue remodeling, modulates the phenotype of scleral fibroblasts, extracellular matrix(ECM)metabolism, and tissue mechanical properties through a multi-signaling axis network, thereby playing a crucial role in myopic scleral remodeling. This article systematically summarizes the core signaling mechanisms of TGF-β-mediated scleral remodeling. As a core driver, TGF-β synergistically promotes scleral remodeling at both transcriptional regulatory and cellular mechanical levels through its two downstream core signaling axes, namely Smad and Rho/ROCK. Bone morphogenetic protein(BMP), an important member of the TGF-β superfamily and a key negative regulator of the core signaling axes, maintains scleral homeostasis by antagonizing the TGF-β/Smad signaling. Additionally, the TGF-β core signaling axes may crosstalk with pathways such as Wnt/β-catenin and PI3K/Akt. This article clarifies the core significance of the TGF-β-mediated signaling axis network in the progression of myopia, provides a systematic framework for understanding the molecular mechanisms of myopic scleral remodeling, and identifies research gaps in areas such as crosstalk molecules among signaling axes, stage-specific functions, and clinical translation. It also offers novel insights for the precise prevention, control, and targeted treatment of myopia.
2.Fluid Suppression Techniques Combined With Amide Proton Transfer-Weighted Imaging for the Evaluation of Adult-Type Diffuse Gliomas
Hongquan ZHU ; Yuanhao LI ; Yujie DING ; Yufei LIU ; Nanxi SHEN ; Yan XIE ; Su YAN ; Dong LIU ; Xiaoxiao ZHANG ; Li LI ; Wenzhen ZHU
Korean Journal of Radiology 2026;27(3):252-263
Objective:
To evaluate the diagnostic potential of fluid suppression (FS) techniques combined with amide proton transferweighted imaging (APTw) for assessment of isocitrate dehydrogenase (IDH) mutation status, glioma subtypes, and tumor proliferation.
Materials and Methods:
This retrospective study included 117 patients with adult-type diffuse gliomas. Conventional APTw, FSAPTw, and spillover-corrected FS-APTw (SCFS-APTw) metrics were calculated from 3T MRI data in tumor parenchyma, necrotic or cystic regions, and contralateral normal-appearing white matter. APTw signals were compared across the three techniques within each region, between IDH-mutant and IDH-wildtype gliomas, and among astrocytoma, oligodendroglioma, and glioblastoma subtypes. Diagnostic performance for distinguishing IDH mutation status and glioma subtypes was assessed using receiver operating characteristic (ROC) analysis. Correlations between APTw metrics and Ki-67 expression were also analyzed.
Results:
Both FS-APTw and SCFS-APTw significantly reduced signal intensity in tumor parenchyma and necrotic or cystic regions, with SCFS-APTw demonstrating a stronger suppression effect. IDH-wildtype gliomas showed significantly higher APTw metrics than IDH-mutant gliomas (all P < 0.001). Glioblastomas exhibited significantly higher metrics than oligodendrogliomas (all corrected P ≤ 0.015) and astrocytomas (all corrected P < 0.001). SCFS-APTw achieved the highest area under the ROC curve (AUC) of 0.846 for identification of IDH mutation status. For differentiation between astrocytomas and glioblastomas, the 90th percentile of APTw yielded the highest AUC (0.860), followed by SCFS-APTw (0.849). For discrimination between oligodendrogliomas and glioblastomas, the highest AUC (0.832) was obtained using the 90th percentile of SCFS-APTw. None of these metrics successfully differentiated oligodendrogliomas from astrocytomas. SCFS-APTw demonstrated the strongest correlation with Ki-67 expression (r = 0.451).
Conclusion
FS techniques effectively reduce elevated APTw signals originating from fluid compartments. Their combination with APTw imaging enables evaluation of IDH mutation status, glioma subtypes, and tumor proliferative activity in adulttype diffuse gliomas.
3.Comparative analysis of centrifugal and membrane double plasma molecular adsorption systems combined with low-dose plasma exchange in the treatment of liver failure
Yan HU ; Bangqiang ZHU ; Haijing WANG ; Peng YANG ; Wei XU ; Maohong BIAN ; Junfei ZHANG ; Zhen DA ; Yujie DIAO
Chinese Journal of Blood Transfusion 2026;39(7):859-866
Objective: To investigate the efficacy and safety of centrifugal and membrane double plasma molecular adsorption systems (DPMAS) combined with low-dose plasma exchange in the treatment of liver failure. Methods: A retrospective analysis was performed on 60 patients with liver failure treated in our hospital from April 2024 to June 2025. Based on different plasma separation methods, they were divided into the centrifugal DPMAS group (n=30) and the conventional membrane DPMAS group (n=30). The operational parameters, laboratory indicators, and adverse reactions were compared between the two groups. Results: Under the same plasma volume for adsorption and exchange (P>0.05), the centrifugal group showed lower total circulating blood volume, total blood flow rate, and treatment duration compared to the membrane group [10 794 (9 532, 12 637) vs 19 000 (19 000, 21 000) mL, 60 (60, 65) vs 125 (120, 130) mL/min, 169 (141, 193) vs 207 (183, 210) min, P<0.001]. The centrifugal group also had a lower rate of central venous catheter use [(24/30, 80.00%) vs (30/30, 100.00%), P=0.024] and required more calcium supplementation due to sodium citrate anticoagulation [6 (6, 8) vs 2 (2, 2) g, P<0.001]. No significant changes were observed in WBC, Hb, HCT, and PLT levels before and after treatment with the centrifugal group (P>0.05). There was no statistically significant difference in WBC levels before and after membrane group treatment (P=0.199), but the values of Hb, HCT, and PLT showed significant decreases post-treatment compared to pre-treatment [106.50 (102.75, 126.75) vs 123.00 (109.75, 132.00) g/L, 33.20 (29.90, 34.92) vs 34.85 (31.55, 37.52)%, 85.00 (43.25, 139.50) vs 93.00 (61.50, 145.00)×10
/L, P<0.05]. There was no significant difference in coagulation function indexes before and after treatment with centrifugal group (P>0.05). The membrane group showed reduction in fibrinogen (Fib) levels post-treatment [1.50 (1.20, 1.60) vs 1.60 (1.25, 1.80) g/L, P=0.033]. Both groups demonstrated significant decreases in total bilirubin (TBil) and direct bilirubin (DBil) levels after treatment (centrifugal group: 194.70 (107.50, 276.00) vs 239.15 (173.00, 304.17) μmol/L, 101.00 (64.00, 182.30) vs 157.00 (101.00, 195.00) μmol/L; membrane group: 211.50 (118.00, 240.00) vs 263.50 (204.75, 314.00) μmol/L, 188.00 (122.75, 232.25) vs 219.00 (178.50, 267.25) μmol/L, P<0.05]. The incidence of catheter-related complications was lower in the centrifugal group [(2/30, 6.67%) vs (8/30, 26.67%), P=0.038]. Conclusion: The centrifugal DPMAS system demonstrates advantages such as lower blood flow velocity requirements, shorter treatment duration, minimal impact on platelets, and reduced adverse event rates, indicating promising clinical applications.
4.Exploring Pathogenesis and Treatment of Gastric Cancer Metastasis Based on Blood Harmonizing Method
Zhongbo ZHU ; Wenying YANG ; Fangni LI ; Yujie YANG ; Jungang DONG ; Xiping LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):63-73
Metastasis in gastric cancer is a key factor contributing to poor prognosis. Its pathogenesis is complex, characterized by a combination of underlying deficiency and superficial excess, cold and heat in complexity, and stagnation in collateral Conventional aggressive treatment methods tend to exacerbate the depletion of healthy Qi and Zang-Fu organ dysfunctions. The harmonizing method in traditional Chinese medicine (TCM) emphasizes holistic regulation and reinforcing healthy Qi while expelling pathogenic factors. The blood harmonizing method is grounded in the core TCM theory of blood vessel transmission and Zang-Fu organ accumulation of cancerous toxins. It closely addresses the essence of metastasis-where cancerous toxins spread through the bloodstream and accumulate in the collaterals-thereby providing a unique and feasible diagnostic and therapeutic approach for clinical intervention in gastric cancer metastasis. This paper systematically reviews relevant TCM theories such as transmission and Zang-Fu organ accumulation of cancerous toxins and accumulation-gathering and provides an in-depth explanation of the core pathogenesis of gastric cancer metastasis. Specifically, cancerous toxins circulate throughout the body via the blood vessels and accumulate in the collaterals of target organs such as the liver, peritoneum, lymph nodes, and lungs. The occurrence and development of this process are consistently centered on the key mechanism of disharmony in blood-related syndromes. On this basis, the paper explicitly proposes three major therapeutic approaches centered on harmonizing the blood. The first is harmonizing the blood to restore ascending and descending functions, thereby invigorating the spleen and regulating the middle energizer to restore the mediating function of the middle energizer and block the generation of phlegm and blood stasis at the root. The second is harmonizing the blood to balance cold and heat, using pungent herbs to open and bitter herbs to descend to harmonize the Yin-Yang balance and improve the homeostasis of the tumor microenvironment. The third is harmonizing the blood to unblock collaterals and resolve stasis, thereby gradually dissipating stasis and nodules, gently clearing obstructions in the collaterals, and breaking the critical link of collateral stagnation forming masses caused by metastasis. The article further summarizes modern pharmacological research findings on representative formulas such as Banxia Xiexintang, Weichang'an, Yangzheng Sanjie decoction, and Sijunzitang, confirming that they can inhibit the proliferation, invasion, and metastasis of gastric cancer cells, as well as epithelial-mesenchymal transition, through multiple targets and pathways, to regulate angiogenesis and lymphangiogenesis, modulate the immune microenvironment, and induce tumor cell apoptosis and ferroptosis, thereby blocking the metastasis process at multiple levels. This paper discusses the theoretical basis, pathogenetic mechanisms, therapeutic systems, and modern mechanisms of the blood harmonizing method for the diagnosis and treatment of gastric cancer metastasis. It fully embodies the TCM principles of targeting balance, reinforcing healthy Qi without aiding the pathogen, and eliminating the pathogen without harming the healthy Qi, providing a solid theoretical foundation and practical pharmacological references for the prevention and treatment of gastric cancer metastasis with integrated traditional Chinese and Western medicine in clinical practice.
5.Exploring Pathogenesis and Treatment of Gastric Cancer Metastasis Based on Blood Harmonizing Method
Zhongbo ZHU ; Wenying YANG ; Fangni LI ; Yujie YANG ; Jungang DONG ; Xiping LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):63-73
Metastasis in gastric cancer is a key factor contributing to poor prognosis. Its pathogenesis is complex, characterized by a combination of underlying deficiency and superficial excess, cold and heat in complexity, and stagnation in collateral Conventional aggressive treatment methods tend to exacerbate the depletion of healthy Qi and Zang-Fu organ dysfunctions. The harmonizing method in traditional Chinese medicine (TCM) emphasizes holistic regulation and reinforcing healthy Qi while expelling pathogenic factors. The blood harmonizing method is grounded in the core TCM theory of blood vessel transmission and Zang-Fu organ accumulation of cancerous toxins. It closely addresses the essence of metastasis-where cancerous toxins spread through the bloodstream and accumulate in the collaterals-thereby providing a unique and feasible diagnostic and therapeutic approach for clinical intervention in gastric cancer metastasis. This paper systematically reviews relevant TCM theories such as transmission and Zang-Fu organ accumulation of cancerous toxins and accumulation-gathering and provides an in-depth explanation of the core pathogenesis of gastric cancer metastasis. Specifically, cancerous toxins circulate throughout the body via the blood vessels and accumulate in the collaterals of target organs such as the liver, peritoneum, lymph nodes, and lungs. The occurrence and development of this process are consistently centered on the key mechanism of disharmony in blood-related syndromes. On this basis, the paper explicitly proposes three major therapeutic approaches centered on harmonizing the blood. The first is harmonizing the blood to restore ascending and descending functions, thereby invigorating the spleen and regulating the middle energizer to restore the mediating function of the middle energizer and block the generation of phlegm and blood stasis at the root. The second is harmonizing the blood to balance cold and heat, using pungent herbs to open and bitter herbs to descend to harmonize the Yin-Yang balance and improve the homeostasis of the tumor microenvironment. The third is harmonizing the blood to unblock collaterals and resolve stasis, thereby gradually dissipating stasis and nodules, gently clearing obstructions in the collaterals, and breaking the critical link of collateral stagnation forming masses caused by metastasis. The article further summarizes modern pharmacological research findings on representative formulas such as Banxia Xiexintang, Weichang'an, Yangzheng Sanjie decoction, and Sijunzitang, confirming that they can inhibit the proliferation, invasion, and metastasis of gastric cancer cells, as well as epithelial-mesenchymal transition, through multiple targets and pathways, to regulate angiogenesis and lymphangiogenesis, modulate the immune microenvironment, and induce tumor cell apoptosis and ferroptosis, thereby blocking the metastasis process at multiple levels. This paper discusses the theoretical basis, pathogenetic mechanisms, therapeutic systems, and modern mechanisms of the blood harmonizing method for the diagnosis and treatment of gastric cancer metastasis. It fully embodies the TCM principles of targeting balance, reinforcing healthy Qi without aiding the pathogen, and eliminating the pathogen without harming the healthy Qi, providing a solid theoretical foundation and practical pharmacological references for the prevention and treatment of gastric cancer metastasis with integrated traditional Chinese and Western medicine in clinical practice.
6.Qingre Lidan Jiedu Recipe improves high copper load-induced cognitive dysfunction in rats by regulating mitophagy.
Yulan WANG ; Xiang FANG ; Zeming CHEN ; Bingkun RUAN ; Xinli HAN ; Yujie TANG ; Luyao ZHU
Journal of Southern Medical University 2025;45(11):2437-2443
OBJECTIVES:
To explore the mechanisms of Qingre Lidan Jiedu Recipe (QLJR) for improving cognitive dysfunction in rats with high copper load.
METHODS:
Seventy-five male SD rats were randomized into normal control group, model group, QLJR group, penicillamine (PCA) group, and QLJR+ PCA group. Except for those in the control group, all the rats were fed a high-copper diet for 12 weeks. The effects of the treatments on cognitive function of the rats were assessed using the Barnes maze and passive avoidance tests. Hippocampal expressions of NIX, FUNDC1 and LC3 of the rats were detected using Western blotting and immunofluorescence staining, and changes in mitochondrial morphology were observed with transmission electron microscopy.
RESULTS:
Behavioral tests showed prolonged target hole latency, shortened latency to enter the dark chamber, and increased error counts of the rats in the model group, which were significantly improved in QLJR+PCA group; the error counts were significantly lower in QLJR+PCA group than in either QLJR or PCA group. Among all the groups, the hippocampal expressions of NIX and FUNDC1 were the lowest and LC3 I/II expression the highest in the model group; NIX and FUNDC1 expressions were significantly higher and LC3 I expression was lower in QLJR+PCA group than in QLJR group and PCA group. Immunofluorescence staining revealed weakened NIX and FUNDC1 expressions and enhanced LC3 expression in the hippocampus of the rats in the model group as compared with those in the normal control and QLJR+PCA groups, but their expressions did not differ significantly between QLJR and PCA groups. The rats in the model group showed obvious structural disarray of the mitochondria, which were improved in all the treatment groups.
CONCLUSIONS
QLJR improves cognitive dysfunction in rats with high copper load possibly by regulating mitophagy.
Animals
;
Male
;
Rats, Sprague-Dawley
;
Rats
;
Drugs, Chinese Herbal/therapeutic use*
;
Copper/toxicity*
;
Mitophagy/drug effects*
;
Hippocampus/drug effects*
;
Cognition Disorders/drug therapy*
;
Cognitive Dysfunction/chemically induced*
7.Disability-adjusted life years for colorectal cancer in China, 2017-2030: A prevalence-based analysis focusing on the impact of screening coverage and the application of local weights.
Yujie WU ; Yanjie LI ; Xin WANG ; Xinyi ZHOU ; Xinxin YAN ; Hong WANG ; Juan ZHU ; Wanqing CHEN ; Jufang SHI
Chinese Medical Journal 2025;138(8):962-972
BACKGROUND:
Most studies have evaluated disability-adjusted life years (DALYs) of colorectal cancer (CRC) patients based on a set of generic disability weights (DWs). This study aimed to apply local CRC-stage-specific DWs to estimate the burden of DALYs for CRC (CRC-DALYs) in populations in China and consider the influence of local screening coverage of CRC.
METHODS:
A prevalence-based model was constructed using data from various sources. Years lived with disability (YLDs) were estimated mainly via cumulative prevalence data (based on CRC incidence rates, population numbers, and survival rates), stage-specific proportions of CRC, and DWs of the local population. Years of life lost (YLLs) were calculated based on the CRC mortality rates and standard life expectancies. CRC incidence and mortality rates for the years 2020, 2025, and 2030 were estimated by joinpoint regression, and the corresponding DALYs were predicted. The main assumption was made for CRC screening coverage. Sensitivity analyses were used to assess the impact of population, DWs, and coverage.
RESULTS:
In 2017, among the Chinese population, the estimated number of CRC-DALYs was 4,303,314 (11.9% for YLDs). If CRC screening coverage rate in China (2.3%) remains unchanged, the overall DALYs in 2030 are predicted to increase by 37.2% (45.1% of those aged ≥65 years). More optimistically, the DALYs would then decrease by 0.7% in 2030 (from 5,902,454 to 5,860,200) if the coverage could be increased to 25.0%. A sensitivity analysis revealed that using local DWs would change the base-case values by 5.7%.
CONCLUSIONS
The estimated CRC-DALYs in China using population-specific DWs were considerably lower (with a higher percentage of YLDs) than the global burden of disease (GBD) estimates (5,865,004, of 4.6% for YLDs), suggesting the impact extent of applying local parameters. Sustainable scale-up CRC screening needs to be in place to moderate the growth trend of CRC-DALYs in China.
Humans
;
Colorectal Neoplasms/diagnosis*
;
China/epidemiology*
;
Disability-Adjusted Life Years
;
Male
;
Prevalence
;
Female
;
Middle Aged
;
Aged
;
Early Detection of Cancer
;
Quality-Adjusted Life Years
;
Adult
;
Incidence
8.Advancements in herbal medicine-based nanozymes for biomedical applications.
Mei YANG ; Zhichao DENG ; Yuanyuan ZHU ; Chenxi XU ; Chenguang DING ; Yujie ZHANG ; Mingxin ZHANG ; Mingzhen ZHANG
Chinese Medical Journal 2025;138(9):1037-1049
Nanozymes are a distinct category of nanomaterials that exhibit catalytic properties resembling those of enzymes such as peroxidase (POD), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx). Nanozymes derived from Chinese herbal medicines exhibit the catalytic functions of their enzyme mimics, while retaining the specific medicinal properties of the herb (termed "herbzymes"). These nanozymes can be categorized into three main groups based on their method of synthesis: herb carbon dot nanozymes, polyphenol-metal nanozymes, and herb extract nanozymes. The reported catalytic activities of herbzymes include POD, SOD, CAT, and GPx. This review presents an overview of the catalytic activities and potential applications of nanozymes, introduces the novel concept of herbzymes, provides a comprehensive review of their classification and synthesis, and discusses recent advances in their biomedical applications. Furthermore, we also discuss the significance of research into herbzymes, including the primary challenges faced and future development directions.
Nanostructures/chemistry*
;
Humans
;
Herbal Medicine/methods*
;
Superoxide Dismutase/chemistry*
;
Catalase/chemistry*
;
Drugs, Chinese Herbal/chemistry*
;
Catalysis
;
Glutathione Peroxidase/chemistry*
9.Drofenine as a Kv2.1 inhibitor alleviated AD-like pathology in mice through Aβ/Kv2.1/microglial NLRP3/neuronal Tau axis.
Jian LU ; Qian ZHOU ; Danyang ZHU ; Hongkuan SONG ; Guojia XIE ; Xuejian ZHAO ; Yujie HUANG ; Peng CAO ; Jiaying WANG ; Xu SHEN
Acta Pharmaceutica Sinica B 2025;15(1):371-391
Alzheimer's disease (AD) is a neurodegenerative disease with clinical hallmarks of progressive cognitive impairment. Synergistic effects of the Aβ-Tau cascade reaction are tightly implicated in AD pathology, and microglial NLRP3 inflammasome activation drives neuronal tauopathy. However, the underlying mechanism of how Aβ mediates NLRP3 inflammasome remains unclear. Herein, we determined that oligomeric Aβ (o-Aβ) bound to microglial Kv2.1 and promoted Kv2.1-dependent potassium efflux to activate NLRP3 inflammasome resulting in neuronal tauopathy by using Kv2.1 inhibitor drofenine (Dfe) as a probe. The underlying mechanism has been intensively investigated by assays with Kv2.1 knockdown in vitro (si-Kv2.1) and in vivo (AAV-ePHP-si-Kv2.1). Dfe deprived o-Aβ of its capability to promote microglial NLRP3 inflammasome activation and neuronal Tau hyperphosphorylation by inhibiting the Kv2.1/JNK/NF-κB pathway while improving the cognitive impairment of 5×FAD-AD model mice. Our results have highly addressed that the Kv2.1 channel is required for o-Aβ-driven microglial NLRP3 inflammasome activation and neuronal tauopathy in AD model mice and highlighted that Dfe as a Kv2.1 inhibitor shows potential in the treatment of AD.
10.Application of next-generation sequencing technology for the investigation of immunoglobulin variable region characteristics and their prognostic significance in patients with chronic lymphocytic leukemia
Zhen GUO ; Huimin JIN ; Tonglu QIU ; Liying ZHU ; Yujie WU ; Hairong QIU ; Yan WANG ; Yi MIAO ; Hui JIN ; Lei FAN ; Jianyong LI ; Yi XIA ; Chun QIAO
Chinese Journal of Hematology 2025;46(3):261-268
Objective:To elucidate the genomic characteristics of the immunoglobulin (IG) heavy-chain variable region and light-chain variable region, the expression of subclones, and the prognostic significance in patients with CLL.Methods:Blood and/or bone marrow specimens were gathered from a cohort of 36 patients with CLL diagnosed at Jiangsu Province Hospital from December 2018 to May 2023, including 12 cases of B cell receptor (BCR) stereotyped patients. IG heavy-chain (IGH) and light-chain (IG Kappa [IGK] and IG lambda [IGL]) gene rearrangements were performed using next-generation sequencing (NGS) technology to analyze the characteristics and prognostic value in CLL.Results:NGS detection of IG variable region (IGHV) demonstrated a significant correlation and superior consistency with Sanger sequencing ( r=0.957, P < 0.001). Among the 36 patients, the IGH variant (IGHV) was observed in 9 (25.0%) but not in 27 (75.0%) participants. The incidence of the MYD88 mutation was higher among patients with mutated IGHV [1/27 (3.7%) vs 4/9 (44.4%), P=0.00]. A high incidence of trisomy 12 was observed in the IGHV #8/#8B subset [4/11 (36.4%) vs 1/25 (4.0%), P=0.023], which were more likely to develop Richter transformation [8/11 (72.7%) vs 4/25 (16.0%), P=0.002]. In the patient cohort, 36 individuals (36/36, 100.0%) used the IGK variable, whereas 15 individuals (15/36, 41.7%) employed the IGL variable (IGLV). IGLV3 - 21 reported the highest utilization rate in IGLV (5/15, 33.3%). Remarkably, patients with CLL with IGLV3-21 fragments were exclusively observed in the Binet C stage and Rai Phase Ⅲ-Ⅳ, with an incidence of del (13) (q14) at 60.0% (3/5). The median time to first treatment (TTFT) of patients with or without IGLV3 - 21 fragments was 5.2 (1.1 - 41.5) and 9.9 (0.1 - 94.4) months, respectively. Using the total reads threshold of 2.5%, 4 (4/36, 11.1%) samples were detected to have two IGHV productive clones. The median TTFT and overall survival (OS) time were 2.8 (0.9-72.7) and 12.8 months in patients with one mutated clone and 57.5 (32.0-120.7) and 51.8 months in those with two mutated clones, respectively. The median TTFT and OS time were 10.9 (0.3-94.4) and 6.3 (0.1 - 12.5) months in patients with one unmutated clone and 49.9 (22.2 - 211.1) and 30.0 (9.6 - 50.3) months in those with multiple unmutated clones, respectively ( P>0.05) . Conclusions:Detection of IG gene rearrangements using NGS technology not only facilitates the analysis of the IGHV mutation status, dominant clones, and prognostic value but also contributes to the exploration of IGK/IGL gene rearrangement fragments and the utilization of subclones. Further, it provides information about the poor prognosis of IGLV3 - 21 CLL. The shortened survival of the two unmutated clone groups in the IGHV unmutated group may indicate a poor prognosis.

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