Objective:To explore the prognostic value of peripheral blood lymphocyte subsets in patients with newly diagnosed multiple myeloma (NDMM) .Methods:The study retrospectively analyzed 133 patients with NDMM admitted to the General Hospital of Tianjin Medical University General Hospital between 2017 and 2022. The least absolute shrinkage and selection operator (LASSO) regression was used to screen the predictive subgroups from the peripheral blood lymphocyte subsets, and the optimal cutoff value was calculated through receiver operating characteristic curve analysis. A nomogram was constructed based on the results of the multiple-factor analysis, and the predictive performance of the nomogram was evaluated by the concordance index and calibration curve. Kaplan-Meier curves and log-rank tests were conducted to compare the differences in overall survival (OS) and progression-free survival between the high-risk and low-risk immune risk scores groups.Results:Using LASSO regression, the percentages and absolute counts of CD16 +CD56 + NK cells, CD3 + T lymphocytes, CD3 +CD8 + T lymphocytes, and CD3 -CD19 + B lymphocytes were selected as predictive subgroups. The immune risk score of patients with NDMM was calculated based on the coefficients of each lymphocyte subgroup. The area under the curve of the immune risk score was 0.737, and the optimal cutoff value was -1.834. Based on this, the patients were divided into high-risk and low-risk groups. Survival analysis showed a significant difference in the 3-year OS rate between the high-risk and low-risk immune risk score groups (87.4% vs 49.0%, P<0.001), and a significant difference in the 3-year OS rate between the high-risk and low-risk immune risk score groups in patients with minimal residual disease negative (100% vs 68.6%, P=0.001). Multivariate analysis showed that serum calcium ( P=0.034), high-risk cytogenetic abnormalities ( P=0.002), and immune risk score ( P<0.001) were prognostic factors for patients with NDMM, and a nomogram was constructed based on these factors. The consistency index of the nomogram was 0.793, and the calibration curve showed good predictive ability. The nomogram can accurately classify the risk of different prognostic staging systems. Conclusions:The combined analysis of lymphocyte subsets in the peripheral blood has an important value in predicting the prognosis of patients with NDMM.

Objective:To explore the prognostic value of peripheral blood lymphocyte subsets in patients with newly diagnosed multiple myeloma (NDMM) .Methods:The study retrospectively analyzed 133 patients with NDMM admitted to the General Hospital of Tianjin Medical University General Hospital between 2017 and 2022. The least absolute shrinkage and selection operator (LASSO) regression was used to screen the predictive subgroups from the peripheral blood lymphocyte subsets, and the optimal cutoff value was calculated through receiver operating characteristic curve analysis. A nomogram was constructed based on the results of the multiple-factor analysis, and the predictive performance of the nomogram was evaluated by the concordance index and calibration curve. Kaplan-Meier curves and log-rank tests were conducted to compare the differences in overall survival (OS) and progression-free survival between the high-risk and low-risk immune risk scores groups.Results:Using LASSO regression, the percentages and absolute counts of CD16 +CD56 + NK cells, CD3 + T lymphocytes, CD3 +CD8 + T lymphocytes, and CD3 -CD19 + B lymphocytes were selected as predictive subgroups. The immune risk score of patients with NDMM was calculated based on the coefficients of each lymphocyte subgroup. The area under the curve of the immune risk score was 0.737, and the optimal cutoff value was -1.834. Based on this, the patients were divided into high-risk and low-risk groups. Survival analysis showed a significant difference in the 3-year OS rate between the high-risk and low-risk immune risk score groups (87.4% vs 49.0%, P<0.001), and a significant difference in the 3-year OS rate between the high-risk and low-risk immune risk score groups in patients with minimal residual disease negative (100% vs 68.6%, P=0.001). Multivariate analysis showed that serum calcium ( P=0.034), high-risk cytogenetic abnormalities ( P=0.002), and immune risk score ( P<0.001) were prognostic factors for patients with NDMM, and a nomogram was constructed based on these factors. The consistency index of the nomogram was 0.793, and the calibration curve showed good predictive ability. The nomogram can accurately classify the risk of different prognostic staging systems. Conclusions:The combined analysis of lymphocyte subsets in the peripheral blood has an important value in predicting the prognosis of patients with NDMM.

Objective To investigate the role of Sneathia sanguinegens(S.sanguinegens)in the development of unexplained recurrent spontaneous abortion(URSA).Methods A case-control study was conducted to analyze the vaginal flora characteristics of 65 patients with URSA and 18 healthy controls through 16S rRNA gene sequencing.Toxicity profile of S.sanguinegens on human cervical cancer cells(ME-180),human umbilical vein endothelial cells(HUVEC)and human placental choriocarcinoma cells(JEG-3)was analyzed at the cellular level to assess the mechanism of it in adverse pregnancy outcomes.And S.sanguinegens was used to infect C57BL/6J mice to explore the toxic effect on living organisms.Results The relative abundance of Sneathia was increased in patients with URSA compared with healthy controls.It was positively correlated with the number of miscarriages,and was attributed to S.sanguinegens.We also found that S.sanguinegens damaged ME-180,JEG-3 and HUVEC cells.The degree of cellular damage was related to the level of S.sanguinegens added.Intravenous infection with S.sanguinegens caused inflammatory damage in several organs and extramedullary hematopoiesis in the spleen.Conclusion S.sanguinegens is closely related to URSA and should be emphasized in patients with high vaginal bacterial load.

Objective To explore the factors influencing cognitive dysfunction in patients with vestibular migraines.Methods The clinical data of 298 patients with vestibular migraine admitted to the Second People's Hospital of Guiyang City from January 2020 to Ja-nuary 2024 were retrospectively analyzed.The patients were divided into a cognitive impairment group(n=55)and a non-cognitive impairment group(n=243).Baseline data such as sex,age,body mass index,and educational level between the two groups of patients were matched using propensity score matching in a 1∶1 ratio.Factors influencing cognitive dysfunction in patients with vestibular migraine were screened using single-factor and multiple logistic regression analyses.Results Fifty pairs of patients were successfully matched.Single-factor and multivariate logistic regression analyses showed that migraine duration≥10 years,sleep disorders,anxiety or depression,threatened migraine,and white matter lesions were risk factors for cognitive impairment in patients with vestibular migraine(P＜0.05).Conclusion Duration of migraine,sleep disorders,anxiety or depression,threatened migraine,and white matter lesions are factors influencing cognitive dysfunction in patients with vestibular migraine.Corresponding intervention strategies can be developed for risk factors to reduce the occurrence of cognitive dysfunction and improve prognosis.

Nonobstructive azoospermia (NOA), one of the most severe types of male infertility, etiology often remains unclear in most cases. Therefore, this study aimed to detect four biallelic detrimental variants (0.5%) in the minichromosome maintenance domain containing 2 ( MCMDC2 ) genes in 768 NOA patients by whole-exome sequencing (WES). Hematoxylin and eosin (H&E) demonstrated that MCMDC2 deleterious variants caused meiotic arrest in three patients (c.1360G>T, c.1956G>T, and c.685C>T) and hypospermatogenesis in one patient (c.94G>T), as further confirmed through immunofluorescence (IF) staining. The single-cell RNA sequencing data indicated that MCMDC2 was substantially expressed during spermatogenesis. The variants were confirmed as deleterious and responsible for patient infertility through bioinformatics and in vitro experimental analyses. The results revealed four MCMDC2 variants related to NOA, which contributes to the current perception of the function of MCMDC2 in male fertility and presents new perspectives on the genetic etiology of NOA.
Humans ; Male ; Azoospermia/genetics* ; Meiosis/genetics* ; Spermatogenesis/genetics* ; Adult ; Exome Sequencing ; Microtubule-Associated Proteins/genetics* ; Alleles ; Infertility, Male/genetics*

Objective To investigate the role of Sneathia sanguinegens(S.sanguinegens)in the development of unexplained recurrent spontaneous abortion(URSA).Methods A case-control study was conducted to analyze the vaginal flora characteristics of 65 patients with URSA and 18 healthy controls through 16S rRNA gene sequencing.Toxicity profile of S.sanguinegens on human cervical cancer cells(ME-180),human umbilical vein endothelial cells(HUVEC)and human placental choriocarcinoma cells(JEG-3)was analyzed at the cellular level to assess the mechanism of it in adverse pregnancy outcomes.And S.sanguinegens was used to infect C57BL/6J mice to explore the toxic effect on living organisms.Results The relative abundance of Sneathia was increased in patients with URSA compared with healthy controls.It was positively correlated with the number of miscarriages,and was attributed to S.sanguinegens.We also found that S.sanguinegens damaged ME-180,JEG-3 and HUVEC cells.The degree of cellular damage was related to the level of S.sanguinegens added.Intravenous infection with S.sanguinegens caused inflammatory damage in several organs and extramedullary hematopoiesis in the spleen.Conclusion S.sanguinegens is closely related to URSA and should be emphasized in patients with high vaginal bacterial load.

Objective To explore the factors influencing cognitive dysfunction in patients with vestibular migraines.Methods The clinical data of 298 patients with vestibular migraine admitted to the Second People's Hospital of Guiyang City from January 2020 to Ja-nuary 2024 were retrospectively analyzed.The patients were divided into a cognitive impairment group(n=55)and a non-cognitive impairment group(n=243).Baseline data such as sex,age,body mass index,and educational level between the two groups of patients were matched using propensity score matching in a 1∶1 ratio.Factors influencing cognitive dysfunction in patients with vestibular migraine were screened using single-factor and multiple logistic regression analyses.Results Fifty pairs of patients were successfully matched.Single-factor and multivariate logistic regression analyses showed that migraine duration≥10 years,sleep disorders,anxiety or depression,threatened migraine,and white matter lesions were risk factors for cognitive impairment in patients with vestibular migraine(P＜0.05).Conclusion Duration of migraine,sleep disorders,anxiety or depression,threatened migraine,and white matter lesions are factors influencing cognitive dysfunction in patients with vestibular migraine.Corresponding intervention strategies can be developed for risk factors to reduce the occurrence of cognitive dysfunction and improve prognosis.

Objective:To investigate the significance and value of peripheral blood lymphocyte subset characteristics in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT) for distinguishing cytomegalovirus (CMV) infection.Methods:This retrospective study gathered data from allo-HSCT patients treated at Beijing Ludaopei Hospital between May 2021 and January 2023. This study included 50 patients in the CMV infection group and 47 patients in the non-CMV infection group. Flow cytometry was used to detect peripheral blood lymphocyte subsets 1 month after the allo-HSCT. The absolute lymphocyte count and their subsets were analyzed to assess their predictive significance in the occurrence of CMV infection. Mamn-whiney U test and χ 2 test were used. Indicators with statistical significance in univariate analysis were further subjected to binary logistic regression analysis and receiver operating characteristic (ROC) curves construction. The generation of survival curves for different outcomes was conducted using the Kaplan-Meier method, and the Log-rank test was applied. A two-sided P-value of<0.05 was considered statistically significant. Results:1. Among patients in the CMV infection group, 22% (11/50) were diagnosed with CMV viremia combined with CMV disease. The maximum CMV viral load in peripheral whole blood in these patients was 1 600 (1 400, 5 800) copies/ml, which was significantly higher than that in patients without confirmed CMV disease 970 (670, 2 300) copies/ml, with a statistically significant difference ( Z=-2.281, P=0.029). 2. The overall survival (OS) at the follow-up endpoint was 80% (40/50) in the CMV infection group and 87.2% (41/47) in the non-CMV infection group. There was no statistically significant difference in OS between the two groups at the follow-up endpoint ( χ2=0.231, P=0.630). 3. In the binary logistic regression model, the number of CD34 cells transfused into the patient, the percentage of CD3+CD38+T cells in CD3+T cells, and the percentage of CD4+CD38+T cells in CD4+lymphocytes were identified as important independent risk factors for infection. The ROC curve analysis demonstrated that the area under the curve (AUC) for these independent risk factors of CMV infection was 0.914 (>0.7, P<0.001), with a decision value of 0.702, a sensitivity of 0.857, and a specificity of 0.844. Conclusion:Followingallo-HSCT, the immune subsets in the CMV infection group exhibited a diminished proportion of T cells and CD4+T cells in comparison to the non-CMV infection group. In terms of T cell differentiation, there was an increase in TEM cells and a decrease in Naive T cells. Additionally, the expression level of the activation marker CD38 on T cells exhibited a high degree of predictive value for the occurrence of CMV infection. Understanding the immune characteristics of post-transplant CMV-infected patients is beneficial for the analysis of their immune reconstitution status, providing valuable insights for clinicians in the diagnosis and treatment of CMV infection after transplantation.

Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

Objective:To investigate the significance and value of peripheral blood lymphocyte subset characteristics in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT) for distinguishing cytomegalovirus (CMV) infection.Methods:This retrospective study gathered data from allo-HSCT patients treated at Beijing Ludaopei Hospital between May 2021 and January 2023. This study included 50 patients in the CMV infection group and 47 patients in the non-CMV infection group. Flow cytometry was used to detect peripheral blood lymphocyte subsets 1 month after the allo-HSCT. The absolute lymphocyte count and their subsets were analyzed to assess their predictive significance in the occurrence of CMV infection. Mamn-whiney U test and χ 2 test were used. Indicators with statistical significance in univariate analysis were further subjected to binary logistic regression analysis and receiver operating characteristic (ROC) curves construction. The generation of survival curves for different outcomes was conducted using the Kaplan-Meier method, and the Log-rank test was applied. A two-sided P-value of<0.05 was considered statistically significant. Results:1. Among patients in the CMV infection group, 22% (11/50) were diagnosed with CMV viremia combined with CMV disease. The maximum CMV viral load in peripheral whole blood in these patients was 1 600 (1 400, 5 800) copies/ml, which was significantly higher than that in patients without confirmed CMV disease 970 (670, 2 300) copies/ml, with a statistically significant difference ( Z=-2.281, P=0.029). 2. The overall survival (OS) at the follow-up endpoint was 80% (40/50) in the CMV infection group and 87.2% (41/47) in the non-CMV infection group. There was no statistically significant difference in OS between the two groups at the follow-up endpoint ( χ2=0.231, P=0.630). 3. In the binary logistic regression model, the number of CD34 cells transfused into the patient, the percentage of CD3+CD38+T cells in CD3+T cells, and the percentage of CD4+CD38+T cells in CD4+lymphocytes were identified as important independent risk factors for infection. The ROC curve analysis demonstrated that the area under the curve (AUC) for these independent risk factors of CMV infection was 0.914 (>0.7, P<0.001), with a decision value of 0.702, a sensitivity of 0.857, and a specificity of 0.844. Conclusion:Followingallo-HSCT, the immune subsets in the CMV infection group exhibited a diminished proportion of T cells and CD4+T cells in comparison to the non-CMV infection group. In terms of T cell differentiation, there was an increase in TEM cells and a decrease in Naive T cells. Additionally, the expression level of the activation marker CD38 on T cells exhibited a high degree of predictive value for the occurrence of CMV infection. Understanding the immune characteristics of post-transplant CMV-infected patients is beneficial for the analysis of their immune reconstitution status, providing valuable insights for clinicians in the diagnosis and treatment of CMV infection after transplantation.