Objective:To analyze overall survival (OS), influential factors, and causes of death in patients with newly diagnosed non-transplant multiple myeloma (NDMM) at grassroots hospitals.Methods:The clinical data of 56 patients with NDMM admitted to the Department of Hematology, Wuwei People's Hospital from January 2018 to October 2022 were retrospectively analyzed. Using the Kaplan-Meier and Cox regression survival analysis models, univariate and multivariate analyses were performed to evaluate the factors affecting the OS of patients with NDMM.Results:The median OS of patients with NDMM was 27 months. Univariate analysis indicated that whether or not to receive chemotherapy was a risk factor affecting OS. Multivariate analysis revealed that age ( HR: 2.215, 95% CI 1.056-4.648, P < 0.05), renal dysfunction ( HR: 3.482, 95% CI 1.359-8.923, P < 0.05), and whether or not to receive chemotherapy ( HR: 0.83, 95% CI 0.021-0.331, P < 0.001) were all significant risk factors affecting OS (all P < 0.05). Conclusions:The median survival time of patients with NDMM is short. Age, renal dysfunction, and not receiving chemotherapy are unfavorable factors affecting OS. Pulmonary infection, renal failure, and disease progression are the main causes of death in patients with NDMM.

Objective To observe the value of artificial intelligence iterative reconstruction(AIIR)for abdominal and pelvic CT examination after total hip arthroplasty(THA).Methods Totally 64 patients after THA who underwent abdominal and pelvic CT examinations were retrospectively collected,including 31 patients received routine CT scanning and 33 patients received dual-energy CT scanning.AIIR and hybrid iterative reconstruction(HIR)algorithms were used to obtain AIIR and HIR images based on conventional CT images,respectively,while 70-140 keV(interval of 5 keV)virtual monoenergetic images(VMI)were reconstructed based on dual-energy CT images.VMI with the best comprehensive imaging qualities were selected for analysis.Subjective scores and objective evaluation results of imaging quality were compared among different kinds of images.Results The subjective scores of artifacts,bones,diagnostic confidence,as well as displaying of pelvic organs and blood vessels on both AIIR images and VMI were all higher than those of HIR images(all P＜0.001),while no significant difference was found between AIIR images and VMI(all P＞0.017).Pairwise comparison of high-density artifact fraction and skeletal artifact fraction on AIIR,HIR images and VMI showed significant differences(all P＜0.001).No significant difference of low density artifact fraction nor high density noise fraction was detected between AIIR image and VMI(both P＞0.017),and the objective evaluation results were different from those of HIR images(both P＜0.017).The low density noise fraction of AIIR images was lower than that of HIR images(P＜0.017),while no significant difference was found between AIIR or HIR images and VMI(both P＞0.017).The bone noise fraction of AIIR and HIR images were both higher than that of VMI(both P＜0.017),while no significant difference was found between these two kinds of images(P＞0.017).Conclusion AIIR could reduce artifacts and image noise of abdominal and pelvic CT examination after THA and improve imaging quality.

Objective:To analyze overall survival (OS), influential factors, and causes of death in patients with newly diagnosed non-transplant multiple myeloma (NDMM) at grassroots hospitals.Methods:The clinical data of 56 patients with NDMM admitted to the Department of Hematology, Wuwei People's Hospital from January 2018 to October 2022 were retrospectively analyzed. Using the Kaplan-Meier and Cox regression survival analysis models, univariate and multivariate analyses were performed to evaluate the factors affecting the OS of patients with NDMM.Results:The median OS of patients with NDMM was 27 months. Univariate analysis indicated that whether or not to receive chemotherapy was a risk factor affecting OS. Multivariate analysis revealed that age ( HR: 2.215, 95% CI 1.056-4.648, P < 0.05), renal dysfunction ( HR: 3.482, 95% CI 1.359-8.923, P < 0.05), and whether or not to receive chemotherapy ( HR: 0.83, 95% CI 0.021-0.331, P < 0.001) were all significant risk factors affecting OS (all P < 0.05). Conclusions:The median survival time of patients with NDMM is short. Age, renal dysfunction, and not receiving chemotherapy are unfavorable factors affecting OS. Pulmonary infection, renal failure, and disease progression are the main causes of death in patients with NDMM.

Objective:To analyze the feasibility and safety of breast-conserving surgery for young women with breast cancer whose tumor is close to nipple areola complex after neoadjuvant therapy.Methods:Young female breast cancer patients treated at Maoming People’s Hospital from Jan. 2016 to Jan. 2022 were selected. The inclusion criteria were primary solitary tumors located within ≤2 cm from the areola margin (excluding carcinoma in situ, nipple discharge, and Paget’s disease), tumor diameter ranging from 1 to 3 cm, and no abnormal adhesion between the tumor and the areola, breast skin, or chest wall. A total of 87 patients were enrolled, including 44 who underwent NAC-sparing breast-conserving surgery (NAC-preservation group) and 43 who underwent breast-conserving surgery without NAC preservation (non-NAC-preservation group). All patients received postoperative radiotherapy and continued systemic therapy. Local recurrence and distant metastasis were compared between the two groups.Results:No statistically significant differences were observed between the two groups in pre-neoadjuvant therapy tumor stage, tumor location, tumor diameter, lymph node metastasis, or molecular subtype ( χ2=0.22, 0.67, 0.80, 1.25, 1.76, respectively; P>0.05). At the 2-year postoperative follow-up, no local recurrence was detected in either group. Distant metastasis occurred in one case in the NAC-preservation group and three cases in the non-NAC-preservation group, with no statistically significant difference (2.27% vs. 6.98%, χ2=1.097, P=0.295) . Conclusions:This study, to some extent, validates the feasibility of both patient groups undergoing breast-conserving surgery with or without NAC preservation after neoadjuvant therapy, in young breast cancer patients with tumors located near the nipple areola complex. Routine NAC excision does not improve therapeutic outcomes.

Objective:To analyze the feasibility and safety of breast-conserving surgery for young women with breast cancer whose tumor is close to nipple areola complex after neoadjuvant therapy.Methods:Young female breast cancer patients treated at Maoming People’s Hospital from Jan. 2016 to Jan. 2022 were selected. The inclusion criteria were primary solitary tumors located within ≤2 cm from the areola margin (excluding carcinoma in situ, nipple discharge, and Paget’s disease), tumor diameter ranging from 1 to 3 cm, and no abnormal adhesion between the tumor and the areola, breast skin, or chest wall. A total of 87 patients were enrolled, including 44 who underwent NAC-sparing breast-conserving surgery (NAC-preservation group) and 43 who underwent breast-conserving surgery without NAC preservation (non-NAC-preservation group). All patients received postoperative radiotherapy and continued systemic therapy. Local recurrence and distant metastasis were compared between the two groups.Results:No statistically significant differences were observed between the two groups in pre-neoadjuvant therapy tumor stage, tumor location, tumor diameter, lymph node metastasis, or molecular subtype ( χ2=0.22, 0.67, 0.80, 1.25, 1.76, respectively; P>0.05). At the 2-year postoperative follow-up, no local recurrence was detected in either group. Distant metastasis occurred in one case in the NAC-preservation group and three cases in the non-NAC-preservation group, with no statistically significant difference (2.27% vs. 6.98%, χ2=1.097, P=0.295) . Conclusions:This study, to some extent, validates the feasibility of both patient groups undergoing breast-conserving surgery with or without NAC preservation after neoadjuvant therapy, in young breast cancer patients with tumors located near the nipple areola complex. Routine NAC excision does not improve therapeutic outcomes.

The expert consensus on the clinical treatment of herpes zoster with fire needling was developed, and the commonly used fire needling treatment scheme verified by clinical research was selected to form a standardized diagnosis and treatment scheme for acute herpes zoster and postherpetic neuralgia (PHN), so as to answer the core problems in clinical application. The consensus focuses on patients with herpes zoster, and forms recommendations for 9 key clinical issues, covering simple fire needling and TCM comprehensive therapy based on fire needling, including fire needling combined with cupping, fire needling combined with Chinese herb, fire needling combined with cupping and Chinese herb, fire needling combined with filiform needling, fire needling combined with moxibustion, and provides specific recommendations and operational guidelines for various therapies.
Humans ; Herpes Zoster/therapy* ; Acupuncture Therapy/instrumentation* ; Consensus ; Clinical Protocols

Adenosine, a critical molecule regulating cellular function both inside and outside cells, is controlled by two human adenosine deaminases: ADA1 and ADA2. While ADA1 primarily resides in the cytoplasm, ADA2 can be transported to lysosomes within cells or secreted outside the cell. Patients with ADA2 deficiency (DADA2) often suffer from systemic vasculitis due to elevated levels of TNF-α in their blood. Monocytes from DADA2 patients exhibit excessive TNF-α secretion and differentiate into pro-inflammatory M1-type macrophages. Our findings demonstrate that ADA2 localizes to endolysosomes within macrophages, and its intracellular concentration decreases in cells secreting TNF-α. This suggests that ADA2 may function as a lysosomal adenosine deaminase, regulating TNF-α expression by the cells. Interestingly, pneumonia patients exhibit higher ADA2 concentrations in their bronchoalveolar lavage (BAL), correlating with elevated pro-inflammatory cytokine levels. Conversely, cord blood has low ADA2 levels, creating a more immunosuppressive environment. Additionally, secreted ADA2 can bind to apoptotic cells, activating immune cells by reducing extracellular adenosine levels. These findings imply that ADA2 release from monocytes during inflammation, triggered by growth factors, may be crucial for cell activation. Targeting intracellular and extracellular ADA2 activities could pave the way for novel therapies in inflammatory and autoimmune disorders.
Humans ; Adenosine Deaminase/deficiency* ; Monocytes/cytology* ; Cell Differentiation ; Intercellular Signaling Peptides and Proteins/metabolism* ; Tumor Necrosis Factor-alpha/metabolism* ; Biomarkers/metabolism* ; Macrophages/metabolism* ; Pneumonia/metabolism*

The study aims to explore the methods for preparing nanocomplexes of Prussian blue nanoparticles (PBNPs) with UNO peptide (UNO-PBNPs) and the functions of the nanocomplexes targeting M2-type macrophages in vitro. PBNPs were prepared by the hydrothermal synthesis method. Subsequently, the peptide UNO (CSPGAKVRC) targeting the mannose receptor was modified on their surface by a heterobifunctional coupling approach. The morphological characteristics of nanoparticles were observed by scanning and transmission electron microscopy. Additionally, their particle size, Zeta potential, and dispersion stability were assessed. The structural characteristics of nanoparticles were analyzed by X-ray diffraction and other techniques. The biological safety of the nanoparticles was evaluated by the CCK-8 assay and hemolysis experiments. Moreover, the targeting performance of UNO-PBNPs towards M2-type macrophages was assessed in vitro. The results showed that the synthesized UNO-PBNPs exhibited uniform cubic morphology, with an average particle size of (202.00±4.21) nm. They were negative charged, well dispersed, and stable. At concentrations ≤ 200 μg/mL, the synthesized UNO-PBNPs led to the hemolysis rate below 5%, demonstrating excellent biocompatibility. The laser confocal imaging results showed that after co-incubation with M2-type macrophages, the FITC-labeled UNO-PBNPs were effectively accumulated in the cells, presenting a distinct fluorescence signal. Quantitative analysis by flow cytometry showed that the intracellular mean fluorescence intensity (6 019.00±346.04) of UNO-PBNPs was higher than that (4 054.00±379.14) of unmodified PBNPs (P < 0.001). In summary, the UNO-PBNPs prepared in this study exhibited a targeting effect on M2-type macrophages, providing a potential method for targeted delivery of PBNPs in the tumor microenvironment and laying a foundation for the remodeling of the tumor immunosuppressive microenvironment.
Ferrocyanides/chemistry* ; Nanoparticles/chemistry* ; Macrophages/drug effects* ; Peptides/chemistry* ; Particle Size ; Animals ; Mannose Receptor ; Mice ; Lectins, C-Type ; Mannose-Binding Lectins ; Receptors, Cell Surface

Objective To observe the value of artificial intelligence iterative reconstruction(AIIR)for abdominal and pelvic CT examination after total hip arthroplasty(THA).Methods Totally 64 patients after THA who underwent abdominal and pelvic CT examinations were retrospectively collected,including 31 patients received routine CT scanning and 33 patients received dual-energy CT scanning.AIIR and hybrid iterative reconstruction(HIR)algorithms were used to obtain AIIR and HIR images based on conventional CT images,respectively,while 70-140 keV(interval of 5 keV)virtual monoenergetic images(VMI)were reconstructed based on dual-energy CT images.VMI with the best comprehensive imaging qualities were selected for analysis.Subjective scores and objective evaluation results of imaging quality were compared among different kinds of images.Results The subjective scores of artifacts,bones,diagnostic confidence,as well as displaying of pelvic organs and blood vessels on both AIIR images and VMI were all higher than those of HIR images(all P＜0.001),while no significant difference was found between AIIR images and VMI(all P＞0.017).Pairwise comparison of high-density artifact fraction and skeletal artifact fraction on AIIR,HIR images and VMI showed significant differences(all P＜0.001).No significant difference of low density artifact fraction nor high density noise fraction was detected between AIIR image and VMI(both P＞0.017),and the objective evaluation results were different from those of HIR images(both P＜0.017).The low density noise fraction of AIIR images was lower than that of HIR images(P＜0.017),while no significant difference was found between AIIR or HIR images and VMI(both P＞0.017).The bone noise fraction of AIIR and HIR images were both higher than that of VMI(both P＜0.017),while no significant difference was found between these two kinds of images(P＞0.017).Conclusion AIIR could reduce artifacts and image noise of abdominal and pelvic CT examination after THA and improve imaging quality.

Alzheimer's disease(AD), the most common neurodegenerative disease, has shown an increasing incidence among younger people. With the onset of disease, most patients' cognitive function will show a progressive decline, bringing a heavy burden to the society and the family. Studies have shown that fibroblast growth factor (FGF) may be involved in the pathogenesis of AD through multiple mechanisms. This article reviews the mechanism of FGF in AD, with the hope of providing new ideas for elucidating the pathogenesis and early diagnosis of AD.