Objective: To evaluate the efficacy and safety of ruxolitinib combined with low-dose hormone for patients with acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: Thirty patients with aGVHD after allo-HSCT admitted to the Department of Hematology of the General Hospital of Western Theater Command from November 2021 to November 2024 were retrospectively analyzed. All patients were treated with low-dose hormone (methylprednisolone 0.3-1 mg kg -d ) combined with ruxolitinib 5-10 mg d . The efficacy and adverse reactions were observed during the follow-up period to analyze the survival outcomes of the patients. Results: A total of 30 patients with aGVHD after allo-HSCT were included in this study, consisting of 15 (50%) males and 15 (50%) females with a median age of 34 year-old (ranging from 14 to 62). Classification by disease type: there were 18 cases of acute myeloid leukemia, 4 cases of acute lymphoblastic leukemia, 4 cases of aplastic anemia, and 4 cases of myelodysplastic syndrome. Classification by aGVHD severity: there were 27 cases (90%) of Ⅱ-Ⅳ degree aGVHD and 11 cases (36.7%) of Ⅲ-Ⅳ degree aGVHD. Ruxolitinib in combination with low-dose glucocorticoid treatment yield responses in 28 (93.3%) patients, of which 27 (90%) achieved complete remission (CR), while 1 (3.3%) showed partial remission (PR). One patient (3.3%) had no response (NR), and 1 patient (3.3%) exhibited progressed disease (PD). Overall survival (OS) at 1 year of transplantation was 73.9% (95%CI 49.5% to 87.7%), progression-free survival (PFS) was 93.3% (95%CI 75.9% to 98.3%), non-relapse mortality (NRM) was 20.6% (95%CI 7.9% to 47.4%), and median survival time was 27.6 months. Conclusion: Ruxolitinib combined with low-dose hormones is safe and effective in the treatment of aGVHD after allo-HSCT.

Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards* ; Humans ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Surveys and Questionnaires

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

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Objective To investigate the diagnostic value of our regression model based on quantitative parameters of dual-energy CT and clinical features for stages T2 and T3 colorectal cancer.Methods A cross-section study was performed on 91 patients with colorectal cancer confirmed by postoperative pathology in our hospital from January 2022 to November 2023.All of them underwent dual-energy CT examination.According to the pathological T staging criteria of Chinese Colorectal Cancer Diagnosis and Treatment Standard(2020 Edition),they were divided into T2 group(n=43)and T3 group(n=48).Univariate analysis was used to compare the differences in quantitative CT parameters and clinical features between the 2 groups,and the obtained significant variables were employed to construct diagnosis models by univariate or multivariate logistic regression analysis.The area under receiver operating characteristic curve(AUC)of the CT parametric model and the model combined with clinical features was compared to evaluate the efficacy of diagnosing T2 and T3 stages.Results Univariate analysis showed that carcinoembryonic antigen(CEA),N stage,tumor location,tumor longest diameter(LD),CT value of virtual noncontrast(CT-VNC),fat fraction,electron density(Rho)and dual energy index(DEI)were significantly different between the T2 and T3 groups(P＜0.05).Multivariate logistic regression analysis found that N stage,tumor location,LD,fat fraction and DEI were independent risk factors for the diagnosis of stage T3.The AUC value of the model of above CT parameters in diagnosing stage T3 colorectal cancer was 0.671(95％CI:0.558～0.783),and the AUC value of the combined model of above CT parameters and clinical features was 0.886(95％CI:0.815～0.957),and statistical difference was observed in the AUC value between the combined model and the CT parametric model(P＜0.01).Conclusion The regression model constructed with dual-energy CT quantitative parameters combined with clinical features has high value in the preoperative diagnosis of stages T2 and T3 colorectal cancer before surgery.

Objective::To investigate the correlation between maternal serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and gestational duration in pregnant women with pulmonary hypertension (PH).Methods::The study included pregnant individuals with PH stemming from mitral valve stenosis and mitral valve regurgitation (post-capillary PH) or pulmonary arterial hypertension (pre-capillary PH) who were admitted to Guangdong Provincial People’s Hospital between January 1, 2014 and December 31, 2020. In this retrospective cohort study, maternal serum NT-proBNP levels during pregnancy, along with other clinical data, were obtained from structured electronic medical records. These data included gestational age at delivery, echocardiographic parameters, laboratory findings, gestational duration, delivery mode, and other relevant clinical variables. Univariate and multivariate regression analyses were conducted to assess the association between NT-proBNP levels and gestational duration. Adjustments were made for potential confounding factors, and curve fitting and threshold effect analysis were employed to identify tangent points. Furthermore, stratified analyses were performed based on tricuspid regurgitation velocity, maternal age, and parity.Results::A total of 64 patients with post-capillary PH and 74 patients with pre-capillary PH were included in this study. Among patients with post-capillary PH, the results of multivariate regression analysis indicated a significant association between maternal NT-proBNP levels and gestational duration (β = -0.03, 95% confidence interval (CI) -0.05 to 0.00, P = 0.02). The fitted curve demonstrated a negative correlation between maternal NT-proBNP levels and gestational duration, with a significant break point at 379.9 ng/L ( P < 0.05). In the post-capillary PH group, the stratified analysis revealed a regression coefficient of -0.05 (95% CI:-0.06 to -0.04, P = 0.001) in patients with a tricuspid regurgitation velocity >340 mm/s. For patients >35 years old, the regression coefficient was -0.03 (95% CI -0.06 to -0.01, P = 0.02). In multiparous women, the regression coefficient was -0.03 (95% CI-0.06 to 0.00, P = 0.03). Conclusion::In pregnant women with pulmonary hypertension, maternal NT-proBNP levels are associated with gestational duration, particularly with an increased risk of preterm labor.

Objective::To investigate the correlation between maternal serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and gestational duration in pregnant women with pulmonary hypertension (PH).Methods::The study included pregnant individuals with PH stemming from mitral valve stenosis and mitral valve regurgitation (post-capillary PH) or pulmonary arterial hypertension (pre-capillary PH) who were admitted to Guangdong Provincial People’s Hospital between January 1, 2014 and December 31, 2020. In this retrospective cohort study, maternal serum NT-proBNP levels during pregnancy, along with other clinical data, were obtained from structured electronic medical records. These data included gestational age at delivery, echocardiographic parameters, laboratory findings, gestational duration, delivery mode, and other relevant clinical variables. Univariate and multivariate regression analyses were conducted to assess the association between NT-proBNP levels and gestational duration. Adjustments were made for potential confounding factors, and curve fitting and threshold effect analysis were employed to identify tangent points. Furthermore, stratified analyses were performed based on tricuspid regurgitation velocity, maternal age, and parity.Results::A total of 64 patients with post-capillary PH and 74 patients with pre-capillary PH were included in this study. Among patients with post-capillary PH, the results of multivariate regression analysis indicated a significant association between maternal NT-proBNP levels and gestational duration (β = -0.03, 95% confidence interval (CI) -0.05 to 0.00, P = 0.02). The fitted curve demonstrated a negative correlation between maternal NT-proBNP levels and gestational duration, with a significant break point at 379.9 ng/L ( P < 0.05). In the post-capillary PH group, the stratified analysis revealed a regression coefficient of -0.05 (95% CI:-0.06 to -0.04, P = 0.001) in patients with a tricuspid regurgitation velocity >340 mm/s. For patients >35 years old, the regression coefficient was -0.03 (95% CI -0.06 to -0.01, P = 0.02). In multiparous women, the regression coefficient was -0.03 (95% CI-0.06 to 0.00, P = 0.03). Conclusion::In pregnant women with pulmonary hypertension, maternal NT-proBNP levels are associated with gestational duration, particularly with an increased risk of preterm labor.

In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands of deaths and chronic physical disabilities every year.This guideline aims to provide practical information to help clinical professionals evaluate and treat snakebite victims.These recommendations are based on clinical experience and clinical research evidence.This guideline focuses on the following topics:snake venom,clinical manifestations,auxiliary examination,diagnosis,treatments,and prevention.

Objective:Based on the specific cleavage and non-specific "trans-cleavage" activities of the clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated protein(CRISPR/Cas13), we established a visually amplification-free rapid detection technique of 2019-nCoV nucleic acid. This technique is easily processed with a low detection limit and good specificity.Methods:According to the 2019-nCoV gene sequence, specific CRISPR RNAs were screened and designed by bioinformatics analysis, and then synthesized as universal signal-strained RNA transcription targets in vitro to establish and optimize the reaction system. Moreover, the 2019-nCoV pseudoviral nucleic acid was used as a standard substance to evaluate the detection limit. A total of 65 positive samples were collected from various 2019-nCoV variants, while 48 negative samples included other clinically common respiratory pathogens, such as influenza A virus, influenza B virus, human parainfluenza virus, Klebsiella pneumonia, etc. All samples were tested by quantitative PCR (qPCR), digital PCR, and the method established in this study. The sensitivity and specificity of the newly established method were analyzed and evaluated. Results:With the newly established technique, the detection time for 2019-nCoV nucleic acid could be minimized to 6 minutes. In addition, the detection limit was 14 copies/μl when assisted by the displaying instrument, whereas it increased to 28 copies/μl with the naked eye. This technique had a sensitivity and specificity of 98.5% (66/67) and 100% (46/46) respectively, showing no statistically significant difference compared to the gold standard qPCR( P=1). Conclusions:This study has successfully established a CRISPR/Cas13a-based visually rapid detection technique for 2019-nCoV nucleic acid. This technique offers the advantages of a simple process, convenient operation, low environmental operating requirements, a detection limit close to qPCR, and a strong potential for on-site testing applications.

Objective To investigate the relationship between the therapeutic effect of anti-vascular endothelial growth factor(VEGF)and cytokines in aqueous humor in patients with diabetic retinopathy(DR).Methods From July 2023 to December 2023,50 DR patients(56 eyes)who were treated with anti-VEGF drugs in the Department of Ophthal-mology,the Third Affiliated Hospital of Xinxiang Medical University were included in this study.The patients were divided into the diabetic macular edema(DME)group(30 patients,36 eyes)and the proliferative DR(PDR)group(20 patients,20 eyes).Patients in the DME group received an intravitreal injection of aflibercept once a month for three consecutive times,with aqueous humor extracted before each injection.Patients in the PDR group received an intravitreal injection of aflibercept one week before vitrectomy,with aqueous humor extracted before injection and during vitrectomy,respective-ly.The concentrations of vascular endothelial growth factor A(VEGF-A),placental growth factor(PLGF),interleukin(IL)-1β,IL-23,IL-17A,and tumor necrosis factor-α(TNF-α)in the aqueous humor were detected using the Luminex as-say.Before injection therapy,all patients underwent best corrected visual acuity(BCVA)and central macular thickness(CMT)examinations,and their correlations with cytokine concentrations in DR patients before injection therapy were ana-lyzed.Results Compared to before injection therapy,the concentrations of VEGF-A,PLGF,and IL-23 in the aqueous humor of patients in the DME group decreased significantly after treatment(all P＜0.05);additionally,the CMT de-creased,and the BCVA increased(both P＜0.05).After injection therapy,the concentrations of VEGF,PLGF,IL-1β,IL-23,IL-17A,and TNF-α in the aqueous humor of patients in the PDR group significantly decreased compared to before injec-tion therapy(all P＜0.05).Before injection therapy,the levels of VEGF-A,PLGF,and IL-23 in the aqueous humor of pa-tients in the DME group were higher than those in the PDR group,and the differences were statistically significant(all P＜0.05).The correlation analysis results showed that before injection therapy,VEGF was negatively correlated with BCVA(r=-0.767,P=0.004)and was positively correlated with CMT(r=0.662,P=0.019)and IL-23(r=0.765,P=0.004)in the DME group.There was no correlation between the cytokines in the aqueous humor of patients in the PDR group be-fore injection therapy(all P＞0.05).Conclusion Changes in the concentration of VEGF-A,PLGF,and IL-23 are closely related to the occurrence and development of DR.Anti-VEGF treatment can improve BCVA and decrease CMT in DME pa-tients.The expression level of IL-23 in aqueous humor can serve as a predictive factor for the anti-VEGF efficacy in DR pa-tients,providing new targets for early diagnosis and treatment of DR.